15D0967691 CLIA NUMBER - JANIS C INGEBRIGTSEN MD

Laboratory Demographics

  • CLIA Code: 15D0967691
  • Facility Name: JANIS C INGEBRIGTSEN MD
  • Facility Address: 1530 N 7TH ST STE 110
    TERRE HAUTE, IN
    ZIP 47807
  • Facility Phone: 812 238-7878
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JANIS C. INGEBIRGTSEN
  • NPI Number: 1609867357
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0967691
LAB Type Physician Office
Facility Name JANIS C INGEBRIGTSEN MD
Street 1530 N 7TH ST STE 110
City TERRE HAUTE
State IN
ZIP 47807
Phone 812 238-7878
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director JANIS C. INGEBIRGTSEN

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