15D0361479 CLIA NUMBER - DEACONESS URGENT CARE NORTH PARK

Laboratory Demographics

  • CLIA Code: 15D0361479
  • Facility Name: DEACONESS URGENT CARE NORTH PARK
  • Facility Address: 4506 N FIRST AVE
    EVANSVILLE, IN
    ZIP 47710
  • Facility Phone: 812 428-6161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETER J. LODICO
  • NPI Number: 1417905688
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0361479
LAB Type Physician Office
Facility Name DEACONESS URGENT CARE NORTH PARK
Street 4506 N FIRST AVE
City EVANSVILLE
State IN
ZIP 47710
Phone 812 428-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2024
Certificate Expiration Date 11/28/2026
Facility Type Physician Office
Lab Director PETER J. LODICO

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