15D2296145 CLIA NUMBER - ETHAN CROSSING ADDICTION CAMPUS OF INDIANAPOLIS

Laboratory Demographics

  • CLIA Code: 15D2296145
  • Facility Name: ETHAN CROSSING ADDICTION CAMPUS OF INDIANAPOLIS
  • Facility Address: 4201 SHORE DRIVE
    INDIANAPOLIS, IN
    ZIP 46254
  • Facility Phone: 513 530-1808
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: OLANIYI OSUNTOKUN
  • NPI Number: 1457022865
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2296145
LAB Type Hospital
Facility Name ETHAN CROSSING ADDICTION CAMPUS OF INDIANAPOLIS
Street 4201 SHORE DRIVE
City INDIANAPOLIS
State IN
ZIP 46254
Phone 513 530-1808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2023
Certificate Expiration Date 12/20/2025
Facility Type Hospital
Lab Director OLANIYI OSUNTOKUN

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