15D2293257 CLIA NUMBER - HOLON HEALTH GREAT LAKES, PC

Laboratory Demographics

  • CLIA Code: 15D2293257
  • Facility Name: HOLON HEALTH GREAT LAKES, PC
  • Facility Address: 675 JUSTICE WAYM ROOM C0049
    INDIANAPOLIS, IN
    ZIP 46203
  • Facility Phone: 804 955-5246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACI M. SWEET
  • NPI Number: 1942902093
  • Taxonomy: 2083A0300X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2293257
LAB Type Physician Office
Facility Name HOLON HEALTH GREAT LAKES, PC
Street 675 JUSTICE WAYM ROOM C0049
City INDIANAPOLIS
State IN
ZIP 46203
Phone 804 955-5246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director TRACI M. SWEET

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