15D1105204 CLIA NUMBER - SUDHEER GURRAM MD

Laboratory Demographics

  • CLIA Code: 15D1105204
  • Facility Name: SUDHEER GURRAM MD
  • Facility Address: 827 S GREEN RIVER RD
    EVANSVILLE, IN
    ZIP 47715
  • Facility Phone: 812 473-7220
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUDHEER GURRAM
  • NPI Number: 1336201243
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1105204
LAB Type Physician Office
Facility Name SUDHEER GURRAM MD
Street 827 S GREEN RIVER RD
City EVANSVILLE
State IN
ZIP 47715
Phone 812 473-7220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Physician Office
Lab Director SUDHEER GURRAM

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