15D0677340 CLIA NUMBER - BOONE CO HEALTH DEPT

Laboratory Demographics

  • CLIA Code: 15D0677340
  • Facility Name: BOONE CO HEALTH DEPT
  • Facility Address: 116 W WASHINGTON ST STE B 202
    LEBANON, IN
    ZIP 46052
  • Facility Phone: 765 482-3942
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: HERSCHEL SERVIES
  • NPI Number: 1184748485
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0677340
LAB Type Other
Facility Name BOONE CO HEALTH DEPT
Street 116 W WASHINGTON ST STE B 202
City LEBANON
State IN
ZIP 46052
Phone 765 482-3942
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 Other
Lab Director HERSCHEL SERVIES

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