15D2317630 CLIA NUMBER - GRANT AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 15D2317630
  • Facility Name: GRANT AMBULATORY SURGERY CENTER
  • Facility Address: 803 WEST GARDNER DR
    MARION, IN
    ZIP 46952
  • Facility Phone: 765 651-4278
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JAYME L. MILLER
  • NPI Number: 1700606340
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2317630
LAB Type Ambulatory Surgery Center
Facility Name GRANT AMBULATORY SURGERY CENTER
Street 803 WEST GARDNER DR
City MARION
State IN
ZIP 46952
Phone 765 651-4278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Ambulatory Surgery Center
Lab Director JAYME L. MILLER

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