Organization
STATE OF INDIANA AUDITOR OF STATE
Active
Other names
Indiana State Department of Health, Indiana Department of Health Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIXIA LIU PHD, D(ABMM) (ASST CMMR & STATE LAB DIRECTOR)
(317) 921-5832
Entity
Organization
Contact information
Practice address
550 W 16TH ST STE B, INDIANAPOLIS, IN 46202-2218
(317) 921-5500
(317) 924-7801
Mailing address
550 W 16TH ST STE B, INDIANAPOLIS, IN 46202-2218
(317) 921-5500
(317) 924-7801
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
15D0662599
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100284680
—
IN
05
—
100284680A
—
IN
Enumeration date
09/14/2010
Last updated
10/06/2020
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