Organization
INDIANA STATE DEPARTMENT OF HEALTH
Active
Parent organization
INDIANA STATE DEPARTMENT OF HEALTH
Other names
Indiana Department of Health State Laboratory, Indiana State Health Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIANA STATE DEPARTMENT OF HEALTH
Authorized official
DR. LIXIA LIU PH.D., D(ABMM) (LABORATORY DIRECTOR)
(317) 921-8509
Entity
Organization
Contact information
Practice address
550 W 16TH STREET, SUTIE B, INDIANAPOLIS, IN 46202-7804
(317) 921-5500
(317) 927-7801
Mailing address
550 W 16TH STREET, SUTIE B, INDIANAPOLIS, IN 46202-7804
(317) 921-5500
(317) 927-7801
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
(LPI):100284680A
—
IN
01
—
15D0662599
CLIA
—
Enumeration date
03/08/2010
Last updated
09/16/2020
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