15D2263714 CLIA NUMBER - YOUR CORNER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 15D2263714
  • Facility Name: YOUR CORNER PEDIATRICS
  • Facility Address: 819 E 64TH SUITE 103
    INDIANAPOLIS, IN
    ZIP 46220
  • Facility Phone: (317) 458-9079
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KATHRYN MCGOVERN
  • NPI Number: 1871368134
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 15D2263714
LAB Type Practitioner Other
Facility Name YOUR CORNER PEDIATRICS
Street 819 E 64TH SUITE 103
City INDIANAPOLIS
State IN
ZIP 46220
Phone 3174589079
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Practitioner Other
Lab Director KATHRYN MCGOVERN

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This page was last updated on: 5/18/2026