15D0361073 CLIA NUMBER - GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES, INC

Laboratory Demographics

  • CLIA Code: 15D0361073
  • Facility Name: GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES, INC
  • Facility Address: 8976 E 800 N
    MONTGOMERY, IN
    ZIP 47558
  • Facility Phone: 812 687-7263
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TOM KIRKWOOD
  • NPI Number: 1528231388
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0361073
LAB Type Physician Office
Facility Name GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES, INC
Street 8976 E 800 N
City MONTGOMERY
State IN
ZIP 47558
Phone 812 687-7263
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director TOM KIRKWOOD

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