15D2066089 CLIA NUMBER - SUNRISE HEALTHCARE

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Laboratory Demographics

CLIA Number: 15D2066089

Facility Name: SUNRISE HEALTHCARE

Facility Address:
410 S CHESTNUT ST
SEYMOUR, IN
ZIP 47274
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Facility Phone Number: 812 405-2125

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487094223

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	15D2066089
LAB Type	Physician Office
Facility Name	SUNRISE HEALTHCARE
Street	410 S CHESTNUT ST
City	SEYMOUR
State	IN
ZIP	47274
Phone	812 405-2125
CertificateType	4
CertificateEffectiveDate	9/20/2023
CertificateExpirationDate	9/19/2025
FacilityType	Waiver

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