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15D0358527 CLIA NUMBER - ASCENSION MEDICAL GROUP ST VINCENT - KOKOMO PRIMARY CARE

Laboratory Demographics

CLIA Number: 15D0358527

Facility Name: ASCENSION MEDICAL GROUP ST VINCENT - KOKOMO PRIMARY CARE

Facility Address:
615 ST JOSEPH DRIVE
KOKOMO, IN
ZIP 46901
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Facility Phone Number: 765 459-4070

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1780625442

Taxonomy: 282N00000X - General Acute Care Hospital
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

CLIA Record

Field Name Field Value
CLIA Number 15D0358527
LAB Type Physician Office
Facility Name ASCENSION MEDICAL GROUP ST VINCENT - KOKOMO PRIMARY CARE
Street 615 ST JOSEPH DRIVE
City KOKOMO
State IN
ZIP 46901
Phone 765 459-4070
CertificateType 4
CertificateEffectiveDate 6/19/2022
CertificateExpirationDate 6/18/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024