15D1074751 CLIA NUMBER - MARTIN FAMILY PRACTICE PC

Laboratory Demographics

  • CLIA Code: 15D1074751
  • Facility Name: MARTIN FAMILY PRACTICE PC
  • Facility Address: 4405 BELLEMEADE AVE STE 102
    EVANSVILLE, IN
    ZIP 47714
  • Facility Phone: 812 437-5554
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK A. MARTIN
  • NPI Number: 1902091143
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1074751
LAB Type Physician Office
Facility Name MARTIN FAMILY PRACTICE PC
Street 4405 BELLEMEADE AVE STE 102
City EVANSVILLE
State IN
ZIP 47714
Phone 812 437-5554
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director MARK A. MARTIN

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