15D1086876 CLIA NUMBER - DEACONESS CLINIC - MARY STREET

Laboratory Demographics

  • CLIA Code: 15D1086876
  • Facility Name: DEACONESS CLINIC - MARY STREET
  • Facility Address: 520 MARY ST STE 340
    EVANSVILLE, IN
    ZIP 47710
  • Facility Phone: 812 450-6700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID M. PAGE
  • NPI Number: 1205082583
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D1086876
LAB Type Physician Office
Facility Name DEACONESS CLINIC - MARY STREET
Street 520 MARY ST STE 340
City EVANSVILLE
State IN
ZIP 47710
Phone 812 450-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Physician Office
Lab Director DR. DAVID M. PAGE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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