15D0924623 CLIA NUMBER - DEACONESS CLINIC WYNTREE

Laboratory Demographics

  • CLIA Code: 15D0924623
  • Facility Name: DEACONESS CLINIC WYNTREE
  • Facility Address: 4144 WYNTREE DR
    NEWBURGH, IN
    ZIP 47630
  • Facility Phone: 812 426-9837
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELINDA B. JACKSON
  • NPI Number: 1740899236
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0924623
LAB Type Physician Office
Facility Name DEACONESS CLINIC WYNTREE
Street 4144 WYNTREE DR
City NEWBURGH
State IN
ZIP 47630
Phone 812 426-9837
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Physician Office
Lab Director MELINDA B. JACKSON

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