CLIA lab
CLIA 15D0356763: Kosciusko Medical GRP LLC /Mentone Family Medicine
Mentone, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D0356763 belongs to Kosciusko Medical GRP LLC /Mentone Family Medicine in Mentone, IN.
Certificate of Waiver, effective December 22, 2024, expires December 21, 2026.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- December 22, 2024
- Certificate expiration
- December 21, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 15D0356763
- Lab name
- Kosciusko Medical GRP LLC /Mentone Family Medicine
- Address
- 515 E Main St, Mentone, IN 46539
- Phone
- (574) 353-7561
- Fax
- (574) 353-7297
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Kosciusko Medical GRP LLC /Mentone Family Medicine in Mentone?
15D0356763, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kosciusko Medical GRP LLC /Mentone Family Medicine hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D0356763 expire?
The CMS file lists December 21, 2026 as the certificate expiration date; the certificate took effect December 22, 2024.