15D2267932 CLIA NUMBER - OPEN DOOR HEALTH SERVICES, INC

Laboratory Demographics

CLIA Number: 15D2267932

Facility Name: OPEN DOOR HEALTH SERVICES, INC

Facility Address:
1651 E 29TH ST
MUNCIE, IN
ZIP 47302
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Facility Phone Number: 765 286-7000

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1023671740

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	15D2267932
LAB Type	Federally Qualified Health Center
Facility Name	OPEN DOOR HEALTH SERVICES, INC
Street	1651 E 29TH ST
City	MUNCIE
State	IN
ZIP	47302
Phone	765 286-7000
CertificateType	4
CertificateEffectiveDate	9/2/2022
CertificateExpirationDate	9/1/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024