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15D0918500 CLIA NUMBER - DEACONESS CLINIC, MOB 2 GATEWAY MEDICAL OFFICE BUILDING

Laboratory Demographics

CLIA Number: 15D0918500

Facility Name: DEACONESS CLINIC, MOB 2 GATEWAY MEDICAL OFFICE BUILDING

Facility Address:
4209 GATEWAY BLVD
NEWBURGH, IN
ZIP 47630
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Facility Phone Number: 812 853-5300

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1205864287

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 15D0918500
LAB Type Physician Office
Facility Name DEACONESS CLINIC, MOB 2 GATEWAY MEDICAL OFFICE BUILDING
Street 4209 GATEWAY BLVD
City NEWBURGH
State IN
ZIP 47630
Phone 812 853-5300
CertificateType 4
CertificateEffectiveDate 5/15/2023
CertificateExpirationDate 5/14/2025
FacilityType Waiver

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