15D2267146 CLIA NUMBER - GREATER INDIANA DIAGNOSTICS LABORATORY LLC

Laboratory Demographics

  • CLIA Code: 15D2267146
  • Facility Name: GREATER INDIANA DIAGNOSTICS LABORATORY LLC
  • Facility Address: 102 LEEDS AVE
    MICHIGAN CITY, IN
    ZIP 46360
  • Facility Phone: 219 561-3877
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JASMINE MCFERSON
  • NPI Number: 1902541626
  • Taxonomy: 3747P1801X - Technician

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CLIA Record

Field Name Field Value
CLIA Number 15D2267146
LAB Type Home Health Agency
Facility Name GREATER INDIANA DIAGNOSTICS LABORATORY LLC
Street 102 LEEDS AVE
City MICHIGAN CITY
State IN
ZIP 46360
Phone 219 561-3877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Home Health Agency
Lab Director JASMINE MCFERSON

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