15D2316358 CLIA NUMBER - LABOLOGY

Laboratory Demographics

  • CLIA Code: 15D2316358
  • Facility Name: LABOLOGY
  • Facility Address: 5130 HICKORY LAKE DRIVE
    INDIANAPOLIS, IN
    ZIP 46235
  • Facility Phone: 317 503-3004
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MARSHEANNA L. MOORE
  • NPI Number: 1356141683
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 15D2316358
LAB Type Mobile Laboratory
Facility Name LABOLOGY
Street 5130 HICKORY LAKE DRIVE
City INDIANAPOLIS
State IN
ZIP 46235
Phone 317 503-3004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Mobile Laboratory
Lab Director MARSHEANNA L. MOORE

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