15D1073608 CLIA NUMBER - TERRE HAUTE SURGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 15D1073608
  • Facility Name: TERRE HAUTE SURGICAL CENTER LLC
  • Facility Address: 227 E MCCALLISTER DR
    TERRE HAUTE, IN
    ZIP 47802
  • Facility Phone: 812 234-4315
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JAN BRAY
  • NPI Number: 1609120344
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 15D1073608
LAB Type Ambulatory Surgery Center
Facility Name TERRE HAUTE SURGICAL CENTER LLC
Street 227 E MCCALLISTER DR
City TERRE HAUTE
State IN
ZIP 47802
Phone 812 234-4315
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Ambulatory Surgery Center
Lab Director JAN BRAY

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