15D2271219 CLIA NUMBER - PRIME SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 15D2271219
  • Facility Name: PRIME SURGERY CENTER
  • Facility Address: 4715 STATESMAN DRIVE, SUITE A
    INDIANAPOLIS, IN
    ZIP 46250
  • Facility Phone: (317) 932-3411
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SAMIULLAH KUNDI
  • NPI Number: 1881319127
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2271219
LAB Type Ambulatory Surgery Center
Facility Name PRIME SURGERY CENTER
Street 4715 STATESMAN DRIVE, SUITE A
City INDIANAPOLIS
State IN
ZIP 46250
Phone 3179323411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Ambulatory Surgery Center
Lab Director SAMIULLAH KUNDI

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