15D2244535 CLIA NUMBER - INDIANA DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 15D2244535
  • Facility Name: INDIANA DIRECT PRIMARY CARE
  • Facility Address: 300 W OHIO STREET
    KENDALLVILLE, IN
    ZIP 46755
  • Facility Phone: 260 449-9279
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JARROD M. WIEGMAN
  • NPI Number: 1154086841
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2244535
LAB Type Physician Office
Facility Name INDIANA DIRECT PRIMARY CARE
Street 300 W OHIO STREET
City KENDALLVILLE
State IN
ZIP 46755
Phone 260 449-9279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director JARROD M. WIEGMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025