15D1058710 CLIA NUMBER - SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC

Laboratory Demographics

CLIA Number: 15D1058710

Facility Name: SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC

Facility Address:
629 LINCOLN AVENUE
BEDFORD, IN
ZIP 47421
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Facility Phone Number: 812 723-3944

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1497074728

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	15D1058710
LAB Type	Federally Qualified Health Center
Facility Name	SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
Street	629 LINCOLN AVENUE
City	BEDFORD
State	IN
ZIP	47421
Phone	812 723-3944
CertificateType	4
CertificateEffectiveDate	2/21/2023
CertificateExpirationDate	2/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024