15D2317507 CLIA NUMBER - DAMAR SERVICES, INC

Laboratory Demographics

CLIA Code: 15D2317507
Facility Name: DAMAR SERVICES, INC
Facility Address: 4840 GRASSELLI ST
EAST CHICAGO, IN
ZIP 46312
Facility Phone: 317 856-5201
Facility Type: Other - RESIDENTIAL SERVICE W/MED
Facility Type: Waiver
Lab Director: JIM L. DALTON
NPI Number: 1992801385
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	15D2317507
LAB Type	Other - RESIDENTIAL SERVICE W/MED
Facility Name	DAMAR SERVICES, INC
Street	4840 GRASSELLI ST
City	EAST CHICAGO
State	IN
ZIP	46312
Phone	317 856-5201
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/27/2025
Certificate Expiration Date	1/26/2027
Facility Type	Other - RESIDENTIAL SERVICE W/MED
Lab Director	JIM L. DALTON

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