15D0862473 CLIA NUMBER - SULLIVAN COUNTY AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 15D0862473
  • Facility Name: SULLIVAN COUNTY AMBULANCE SERVICE
  • Facility Address: 2200 N SECTION ST
    SULLIVAN, IN
    ZIP 47882
  • Facility Phone: 812 268-4311
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: WILLIAM E. SMITH
  • NPI Number: 1790788537
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 15D0862473
LAB Type Other
Facility Name SULLIVAN COUNTY AMBULANCE SERVICE
Street 2200 N SECTION ST
City SULLIVAN
State IN
ZIP 47882
Phone 812 268-4311
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 Other
Lab Director WILLIAM E. SMITH

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