15D0923906 CLIA NUMBER - DEACONESS CLINIC INC/FT BRANCH

Laboratory Demographics

  • CLIA Code: 15D0923906
  • Facility Name: DEACONESS CLINIC INC/FT BRANCH
  • Facility Address: 802 E OAK ST
    FORT BRANCH, IN
    ZIP 47648
  • Facility Phone: 812 753-3942
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JARED KOCHER
  • NPI Number: 1285880179
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0923906
LAB Type Physician Office
Facility Name DEACONESS CLINIC INC/FT BRANCH
Street 802 E OAK ST
City FORT BRANCH
State IN
ZIP 47648
Phone 812 753-3942
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Physician Office
Lab Director JARED KOCHER

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