15D0362095 CLIA NUMBER - UMG CLINTON MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 15D0362095
  • Facility Name: UMG CLINTON MEDICAL CLINIC
  • Facility Address: 819 SO 3RD ST
    CLINTON, IN
    ZIP 47842
  • Facility Phone: 765 832-2464
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANIS C. INGEBRIGTSEN
  • NPI Number: 1225188519
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0362095
LAB Type Physician Office
Facility Name UMG CLINTON MEDICAL CLINIC
Street 819 SO 3RD ST
City CLINTON
State IN
ZIP 47842
Phone 765 832-2464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director JANIS C. INGEBRIGTSEN

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