CLIA lab
CLIA 15D1090923: Premise Health of Indiana Medical, PC
Shipshewana, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D1090923 belongs to Premise Health of Indiana Medical, PC in Shipshewana, IN.
Certificate of Waiver, effective October 22, 2026, expires October 21, 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 of Waiver
- Certificate effective
- October 22, 2026
- Certificate expiration
- October 21, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 22, 2008
- 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
- 15D1090923
- Lab name
- Premise Health of Indiana Medical, PC
- Address
- 750 E Middlebury St, Shipshewana, IN 46565
- Phone
- (877) 685-5884
- Fax
- (260) 768-4823
Annual test volume the lab reported
- Waived tests
- 50
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Shipshewana, IN
- Community Health Clinic, theCertificate of Waiver, Rural health clinic15D2228234
- Midwest Eye Consultants #43Certificate of Waiver, Physician office15D2147581
- Parkview Occup Health CT LagrangeCertificate of Waiver, Other15D1079698
- Parkview Phy GRP Family Medicine - ShipshewanaCertificate for Provider-Performed Microscopy Procedures, Physician office15D1055795
- Shipshewana Family MedicineCertificate for Provider-Performed Microscopy Procedures, Physician office15D0357721
Related
Questions
What is the CLIA number for Premise Health of Indiana Medical, PC in Shipshewana?
15D1090923, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Premise Health of Indiana Medical, PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D1090923 expire?
The CMS file lists October 21, 2028 as the certificate expiration date; the certificate took effect October 22, 2026.