15D0359372 CLIA NUMBER - SOUTHERN INDIANA PEDIATRICS, PSC

Laboratory Demographics

  • CLIA Code: 15D0359372
  • Facility Name: SOUTHERN INDIANA PEDIATRICS, PSC
  • Facility Address: 1701 SPRING STREET, SUITE A
    JEFFERSONVILLE, IN
    ZIP 47130
  • Facility Phone: 812 282-1367
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: LYNN GULLEY
  • NPI Number: 1811043854
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 15D0359372
LAB Type Physician Office
Facility Name SOUTHERN INDIANA PEDIATRICS, PSC
Street 1701 SPRING STREET, SUITE A
City JEFFERSONVILLE
State IN
ZIP 47130
Phone 812 282-1367
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Physician Office
Lab Director LYNN GULLEY

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This page was last updated on: 9/29/2025