15D2090368 CLIA NUMBER - PROACTIVE MD KNOX HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 15D2090368
  • Facility Name: PROACTIVE MD KNOX HEALTH CENTER
  • Facility Address: 307 CARLSON DR
    KNOX, IN
    ZIP 46534
  • Facility Phone: 844 458-2800
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JESSICA GLINSKI
  • NPI Number: 1861945842
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2090368
LAB Type Practitioner Other
Facility Name PROACTIVE MD KNOX HEALTH CENTER
Street 307 CARLSON DR
City KNOX
State IN
ZIP 46534
Phone 844 458-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Practitioner Other
Lab Director JESSICA GLINSKI

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