SIA OCCUPATIONAL MEDICAL CLINIC
NPI 1255085379
Clinic/Center - Multi-Specialty in Lafayette, IN

NPI Status: Active since February 08, 2022

Contact Information

5500 STATE ROAD 38 E
LAFAYETTE, IN
ZIP 47905
Phone: (765) 588-5667
Fax: (765) 449-8408

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • CLIA Number: 15D2080052
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-29-2026

About SIA OCCUPATIONAL MEDICAL CLINIC

This page provides the complete NPI Profile along with additional information for Sia Occupational Medical Clinic, a provider established in Lafayette, Indiana operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1255085379 assigned on February 2022. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Sia Occupational Medical Clinic. The authorized official of this NPI record is Jon Leizman (President)

NPI
1255085379
Provider Legal Name
PREMISE HEALTH OF INDIANA MEDICAL, P.C.
Other Organization Name
SIA OCCUPATIONAL MEDICAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
5500 STATE ROAD 38 E LAFAYETTE, IN 47905
Location Phone
(765) 588-5667
Location Fax
(765) 449-8408
Mailing Address
5500 MARYLAND WAY STE 120 BRENTWOOD, TN 37027
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-08-2022
Last Update Date
08-25-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JON LEIZMAN

Authorized Official Title
PRESIDENT
Authorized Official Phone
(216) 479-9063

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
15D2080052
Facility Type
Physician Office
Certificate Effective Date
June 30, 2024
Certificate Expiration Date
June 29, 2026
Laboratory Director
SEAN SHARMA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Sia Occupational Medical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1255085379, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 0 → 0 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 0 + 5 + 0 + 8 + 1 + 0 + 3 + 1 + 4 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1255085379.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
5500 STATE ROAD 38 E
LAFAYETTE, IN 47905
Nurse Practitioner
5500 STATE ROAD 38 E
LAFAYETTE, IN 47905

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255085379, enumerated as an "organization" on February 08, 2022.

The provider is located at 5500 STATE ROAD 38 E LAFAYETTE, IN 47905 and the phone number is (765) 588-5667.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.