15D0672448 CLIA NUMBER - JEFFERSON CO HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 15D0672448
  • Facility Name: JEFFERSON CO HEALTH DEPARTMENT
  • Facility Address: 715 GREEN RD
    MADISON, IN
    ZIP 47250
  • Facility Phone: 812 273-1942
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: BLYTHE E. COUCH
  • NPI Number: 1780731059
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 15D0672448
LAB Type Rural Health Clinic
Facility Name JEFFERSON CO HEALTH DEPARTMENT
Street 715 GREEN RD
City MADISON
State IN
ZIP 47250
Phone 812 273-1942
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Rural Health Clinic
Lab Director BLYTHE E. COUCH

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