15D0679026 CLIA NUMBER - PERRY COUNTY HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 15D0679026

Facility Name: PERRY COUNTY HEALTH DEPARTMENT

Facility Address:
3214 TELL ST, #1 PERRY COUNTY ARMORY ANNEX
TELL CITY, IN
ZIP 47586
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Facility Phone Number: 812 547-2746

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1053468884

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	15D0679026
LAB Type	Community Clinic
Facility Name	PERRY COUNTY HEALTH DEPARTMENT
Street	3214 TELL ST, #1 PERRY COUNTY ARMORY ANNEX
City	TELL CITY
State	IN
ZIP	47586
Phone	812 547-2746
CertificateType	4
CertificateEffectiveDate	7/9/2023
CertificateExpirationDate	7/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024