15D0971849 CLIA NUMBER - SAINT CHARLES SURGICAL PAVILION INC

Laboratory Demographics

  • CLIA Code: 15D0971849
  • Facility Name: SAINT CHARLES SURGICAL PAVILION INC
  • Facility Address: 1900 ST CHARLES ST
    JASPER, IN
    ZIP 47546
  • Facility Phone: 812 634-1211
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RANDALL G. NORRIS
  • NPI Number: 1295810109
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 15D0971849
LAB Type Ambulatory Surgery Center
Facility Name SAINT CHARLES SURGICAL PAVILION INC
Street 1900 ST CHARLES ST
City JASPER
State IN
ZIP 47546
Phone 812 634-1211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Ambulatory Surgery Center
Lab Director RANDALL G. NORRIS

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