15D1029972 CLIA NUMBER - FIRST CAPITAL MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 15D1029972
  • Facility Name: FIRST CAPITAL MEDICAL GROUP
  • Facility Address: 1263 HOSPITAL DRIVE SW STE 250
    CORYDON, IN
    ZIP 47112
  • Facility Phone: 812 738-4915
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JON HALL
  • NPI Number: 1760598049
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1029972
LAB Type Physician Office
Facility Name FIRST CAPITAL MEDICAL GROUP
Street 1263 HOSPITAL DRIVE SW STE 250
City CORYDON
State IN
ZIP 47112
Phone 812 738-4915
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DR. JON HALL

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