15D2124897 CLIA NUMBER - TERRE HAUTE DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2124897
  • Facility Name: TERRE HAUTE DIALYSIS
  • Facility Address: 504 6TH AVE
    TERRE HAUTE, IN
    ZIP 47807
  • Facility Phone: 812 231-8560
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KUMAR GAURAV
  • NPI Number: 1164972550
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2124897
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TERRE HAUTE DIALYSIS
Street 504 6TH AVE
City TERRE HAUTE
State IN
ZIP 47807
Phone 812 231-8560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KUMAR GAURAV

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