15D0915626 CLIA NUMBER - AGAPE OBGYN PC

Laboratory Demographics

  • CLIA Code: 15D0915626
  • Facility Name: AGAPE OBGYN PC
  • Facility Address: 1140 WASHINGTON SQUARE MALL
    EVANSVILLE, IN
    ZIP 47715
  • Facility Phone: 812 475-8975
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACY SUMMERS
  • NPI Number: 1023351467
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 15D0915626
LAB Type Physician Office
Facility Name AGAPE OBGYN PC
Street 1140 WASHINGTON SQUARE MALL
City EVANSVILLE
State IN
ZIP 47715
Phone 812 475-8975
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director STACY SUMMERS

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