15D2048784 CLIA NUMBER - WITHAM HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 15D2048784
  • Facility Name: WITHAM HEALTH SERVICES
  • Facility Address: 2705 N LEBANON ST STE 265
    LEBANON, IN
    ZIP 46052
  • Facility Phone: (765) 485-8852
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRYSTAL L. JONES
  • NPI Number: 1083750293
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2048784
LAB Type Physician Office
Facility Name WITHAM HEALTH SERVICES
Street 2705 N LEBANON ST STE 265
City LEBANON
State IN
ZIP 46052
Phone 7654858852
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Physician Office
Lab Director CRYSTAL L. JONES

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This page was last updated on: 5/18/2026