CLIA lab
CLIA 15D0718065: Kosciusko Medical Group LLC /
Syracuse, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D0718065 belongs to Kosciusko Medical Group LLC / in Syracuse, IN.
Certificate for Provider-Performed Microscopy Procedures, effective February 26, 2026, expires February 25, 2028.
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 for Provider-Performed Microscopy Procedures
- Certificate effective
- February 26, 2026
- Certificate expiration
- February 25, 2028
- 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
- 15D0718065
- Lab name
- Kosciusko Medical Group LLC /
- Additional name
- Northern Lakes Family Medicine
- Address
- 107 W Pickwick Dr, Ste A, Syracuse, IN 46567
- Phone
- (574) 457-8585
- Fax
- (574) 457-8755
Annual test volume the lab reported
- Waived tests
- 350
- Provider-performed microscopy tests
- 1,000
- Total
- 1,350
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Syracuse, IN
- Appleseed Eyecare SyracuseCertificate of Waiver, Other practitioner15D2284224
- Bowen Health Clinic- SyracuseCertificate of Waiver, Federally qualified health center15D2338521
- Syracuse Family PracticeCertificate for Provider-Performed Microscopy Procedures, Physician office15D0356972
- Syracuse Fire DeptCertificate of Waiver, Mobile lab15D0914388
- Waters of Syracuse Skilled Nursing Facility, theCertificate of Waiver, Skilled nursing or nursing facility15D0666389
Related
Questions
What is the CLIA number for Kosciusko Medical Group LLC / in Syracuse?
15D0718065, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kosciusko Medical Group LLC / hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 15D0718065 expire?
The CMS file lists February 25, 2028 as the certificate expiration date; the certificate took effect February 26, 2026.