15D2305491 CLIA NUMBER - UCHICAGO MEDICINE CROWN POINT AMBULATORY LABORATORY

Laboratory Demographics

  • CLIA Code: 15D2305491
  • Facility Name: UCHICAGO MEDICINE CROWN POINT AMBULATORY LABORATORY
  • Facility Address: 10855 VIRGINIA STREET ROOM 1607
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: 219 407-5540
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. MARK J. ROBERTS
  • NPI Number: 1306525837
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2305491
LAB Type Physician Office
Facility Name UCHICAGO MEDICINE CROWN POINT AMBULATORY LABORATORY
Street 10855 VIRGINIA STREET ROOM 1607
City CROWN POINT
State IN
ZIP 46307
Phone 219 407-5540
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Physician Office
Lab Director DR. MARK J. ROBERTS

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