15D2307940 CLIA NUMBER - ILLINOIS DERMATOLOGY INSTITUTE

Laboratory Demographics

  • CLIA Code: 15D2307940
  • Facility Name: ILLINOIS DERMATOLOGY INSTITUTE
  • Facility Address: 9601 CALUMET AVE (SUITE E)
    MUNSTER, IN
    ZIP 46321
  • Facility Phone: 219 491-3376
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RUCHIK S. DESAI
  • NPI Number: 1972264901
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 15D2307940
LAB Type Physician Office
Facility Name ILLINOIS DERMATOLOGY INSTITUTE
Street 9601 CALUMET AVE (SUITE E)
City MUNSTER
State IN
ZIP 46321
Phone 219 491-3376
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Physician Office
Lab Director RUCHIK S. DESAI

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This page was last updated on: 6/4/2025