15D1030726 CLIA NUMBER - GREENTREE PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 15D1030726
  • Facility Name: GREENTREE PRIMARY CARE LLC
  • Facility Address: 207 E LEWIS & CLARK PKWY STE C
    CLARKSVILLE, IN
    ZIP 47129
  • Facility Phone: 812 280-7965
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CYRUS K. JOSHI
  • NPI Number: 1558402834
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1030726
LAB Type Physician Office
Facility Name GREENTREE PRIMARY CARE LLC
Street 207 E LEWIS & CLARK PKWY STE C
City CLARKSVILLE
State IN
ZIP 47129
Phone 812 280-7965
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director CYRUS K. JOSHI

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