Organization
FAMILIAR FACES CLINICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SASHA M ODOM CCMA (CEO/ADMINISTRATOR)
(463) 221-2605
Entity
Organization
Contact information
Practice address
2426 55TH PL, INDIANAPOLIS, IN 46220-3502
(463) 221-2605
(463) 221-2507
Mailing address
2426 55TH PL, INDIANAPOLIS, IN 46220-3502
(463) 221-2605
(463) 221-2507
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/26/2025
Last updated
05/26/2025
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