15D0666032 CLIA NUMBER - WESTERN INDIANA COMMUNITY ACTION AGENCY INC

Laboratory Demographics

  • CLIA Code: 15D0666032
  • Facility Name: WESTERN INDIANA COMMUNITY ACTION AGENCY INC
  • Facility Address: 705 S 5TH STREET
    TERRE HAUTE, IN
    ZIP 47807
  • Facility Phone: 812 242-6244
  • Facility Type: Other - WIC CLINIC
  • Facility Type: Waiver
  • Lab Director: MELISSA BENNETT
  • NPI Number: 1790286300
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0666032
LAB Type Other - WIC CLINIC
Facility Name WESTERN INDIANA COMMUNITY ACTION AGENCY INC
Street 705 S 5TH STREET
City TERRE HAUTE
State IN
ZIP 47807
Phone 812 242-6244
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 Other - WIC CLINIC
Lab Director MELISSA BENNETT

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