15D2273451 CLIA NUMBER - MENDING MINDS, LLC

Laboratory Demographics

  • CLIA Code: 15D2273451
  • Facility Name: MENDING MINDS, LLC
  • Facility Address: 3900 SOUTHLAND AVE
    KOKOMO, IN
    ZIP 46902
  • Facility Phone: 765 437-1458
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LINDSAY RUSSELL
  • NPI Number: 1780258798
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 15D2273451
LAB Type Physician Office
Facility Name MENDING MINDS, LLC
Street 3900 SOUTHLAND AVE
City KOKOMO
State IN
ZIP 46902
Phone 765 437-1458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Physician Office
Lab Director LINDSAY RUSSELL

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