15D0860307 CLIA NUMBER - EDWARD LONG JR MD

Laboratory Demographics

  • CLIA Code: 15D0860307
  • Facility Name: EDWARD LONG JR MD
  • Facility Address: 24068 PROFESSIONAL PARK DR
    LAWRENCEBURG, IN
    ZIP 47025
  • Facility Phone: 812 637-2323
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. EDWARD LONG JR
  • NPI Number: 1598797938
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0860307
LAB Type Physician Office
Facility Name EDWARD LONG JR MD
Street 24068 PROFESSIONAL PARK DR
City LAWRENCEBURG
State IN
ZIP 47025
Phone 812 637-2323
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 Physician Office
Lab Director DR. EDWARD LONG JR

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