15D0951249 CLIA NUMBER - LOOGOOTEE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 15D0951249

Facility Name: LOOGOOTEE FAMILY MEDICINE

Facility Address:
105 COOPER ST
LOOGOOTEE, IN
ZIP 47553
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Facility Phone Number: 812 295-2812

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1740360700

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	15D0951249
LAB Type	Physician Office
Facility Name	LOOGOOTEE FAMILY MEDICINE
Street	105 COOPER ST
City	LOOGOOTEE
State	IN
ZIP	47553
Phone	812 295-2812
CertificateType	3
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	PPMP

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