15D2268360 CLIA NUMBER - ANTWAN MARDINI MD

Laboratory Demographics

  • CLIA Code: 15D2268360
  • Facility Name: ANTWAN MARDINI MD
  • Facility Address: 1530 N 7TH ST, SUITE 111
    TERRE HAUTE, IN
    ZIP 47807
  • Facility Phone: 812 232-9663
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTWAN M. MARDINI
  • NPI Number: 1982678470
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2268360
LAB Type Physician Office
Facility Name ANTWAN MARDINI MD
Street 1530 N 7TH ST, SUITE 111
City TERRE HAUTE
State IN
ZIP 47807
Phone 812 232-9663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director ANTWAN M. MARDINI

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