15D2278479 CLIA NUMBER - LABLIFE PHLEBOTOMY SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 15D2278479
  • Facility Name: LABLIFE PHLEBOTOMY SERVICES, LLC
  • Facility Address: 607 S LAKE STREET UNIT D 1
    GARY, IN
    ZIP 46403
  • Facility Phone: 219 285-1522
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: CHANEEN R. MOSLEY
  • NPI Number: 1174387351
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 15D2278479
LAB Type Independent
Facility Name LABLIFE PHLEBOTOMY SERVICES, LLC
Street 607 S LAKE STREET UNIT D 1
City GARY
State IN
ZIP 46403
Phone 219 285-1522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Independent
Lab Director CHANEEN R. MOSLEY

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