15D0672355 CLIA NUMBER - STANLEY R DRAKE MD

Laboratory Demographics

  • CLIA Code: 15D0672355
  • Facility Name: STANLEY R DRAKE MD
  • Facility Address: 3401 S 4TH STREET
    TERRE HAUTE, IN
    ZIP 47802
  • Facility Phone: 812 232-6613
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: STANLEY R. DRAKE
  • NPI Number: 1992722490
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 15D0672355
LAB Type Physician Office
Facility Name STANLEY R DRAKE MD
Street 3401 S 4TH STREET
City TERRE HAUTE
State IN
ZIP 47802
Phone 812 232-6613
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director STANLEY R. DRAKE

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