15D1090214 CLIA NUMBER - VINCENNES CBOC

Laboratory Demographics

  • CLIA Code: 15D1090214
  • Facility Name: VINCENNES CBOC
  • Facility Address: 1813 WILLOW ST
    VINCENNES, IN
    ZIP 47591
  • Facility Phone: 812 882-0894
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Accreditation
  • Lab Director: DON R. DOMENICO
  • NPI Number: 1376748996
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 15D1090214
LAB Type Ambulatory Surgery Center
Facility Name VINCENNES CBOC
Street 1813 WILLOW ST
City VINCENNES
State IN
ZIP 47591
Phone 812 882-0894
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/6/2008
Certificate Expiration Date 5/22/2026
Facility Type Ambulatory Surgery Center
Lab Director DON R. DOMENICO

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