15D1088239 CLIA NUMBER - AIR-EVAC 039

Laboratory Demographics

  • CLIA Code: 15D1088239
  • Facility Name: AIR-EVAC 039
  • Facility Address: 481 E CR 600 N
    BRAZIL, IN
    ZIP 47834
  • Facility Phone: 812 448-1880
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: LORI MAYLE
  • NPI Number: 1598748311
  • Taxonomy: 3416A0800X - Ambulance

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D1088239
LAB Type Ambulance
Facility Name AIR-EVAC 039
Street 481 E CR 600 N
City BRAZIL
State IN
ZIP 47834
Phone 812 448-1880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Ambulance
Lab Director LORI MAYLE

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