15D0965649 CLIA NUMBER - DEACONESS CLINIC, INC

Laboratory Demographics

  • CLIA Code: 15D0965649
  • Facility Name: DEACONESS CLINIC, INC
  • Facility Address: 8600 UNIVERSITY BLVD FC363
    EVANSVILLE, IN
    ZIP 47712
  • Facility Phone: 812 465-1250
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BRENT THOMASON
  • NPI Number: 1093000283
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0965649
LAB Type Physician Office
Facility Name DEACONESS CLINIC, INC
Street 8600 UNIVERSITY BLVD FC363
City EVANSVILLE
State IN
ZIP 47712
Phone 812 465-1250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Physician Office
Lab Director DR. BRENT THOMASON

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