15D2006166 CLIA NUMBER - DEACONESS CLINIC REO

Laboratory Demographics

CLIA Number: 15D2006166

Facility Name: DEACONESS CLINIC REO

Facility Address:
3434 W SR 66
ROCKPORT, IN
ZIP 47635
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Facility Phone Number: 812 649-5061

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699921585

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 15D2006166
LAB Type Physician Office
Facility Name DEACONESS CLINIC REO
Street 3434 W SR 66
City ROCKPORT
State IN
ZIP 47635
Phone 812 649-5061
CertificateType 4
CertificateEffectiveDate 4/22/2023
CertificateExpirationDate 4/21/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024