15D2317799 CLIA NUMBER - WILLIAMS PERSONALIZED CARE, LLC

Laboratory Demographics

  • CLIA Code: 15D2317799
  • Facility Name: WILLIAMS PERSONALIZED CARE, LLC
  • Facility Address: 2525 SOUTH ST, STE A
    LAFAYETTE, IN
    ZIP 47904
  • Facility Phone: 765 809-2320
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK H. WILLIAMS
  • NPI Number: 1417766742
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2317799
LAB Type Physician Office
Facility Name WILLIAMS PERSONALIZED CARE, LLC
Street 2525 SOUTH ST, STE A
City LAFAYETTE
State IN
ZIP 47904
Phone 765 809-2320
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Physician Office
Lab Director MARK H. WILLIAMS

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