15D0663950 CLIA NUMBER - PUTNAM COUNTY HOSPITAL DBA THE WATERS OF MARTINSVILLE

Laboratory Demographics

  • CLIA Code: 15D0663950
  • Facility Name: PUTNAM COUNTY HOSPITAL DBA THE WATERS OF MARTINSVILLE
  • Facility Address: 2055 HERITAGE DR
    MARTINSVILLE, IN
    ZIP 46151
  • Facility Phone: 765 342-3305
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LACI CROSLEY
  • NPI Number: 1720026180
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0663950
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PUTNAM COUNTY HOSPITAL DBA THE WATERS OF MARTINSVILLE
Street 2055 HERITAGE DR
City MARTINSVILLE
State IN
ZIP 46151
Phone 765 342-3305
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 Skilled Nursing Facility/Nursing Facility
Lab Director LACI CROSLEY

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