15D2152013 CLIA NUMBER - DEACONESS CLINIC AT WORK FIRST AVE

Laboratory Demographics

  • CLIA Code: 15D2152013
  • Facility Name: DEACONESS CLINIC AT WORK FIRST AVE
  • Facility Address: 315 N FIRST AVE
    EVANSVILLE, IN
    ZIP 47710
  • Facility Phone: 812 450-4066
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT ULOTH
  • NPI Number: 1659860971
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2152013
LAB Type Physician Office
Facility Name DEACONESS CLINIC AT WORK FIRST AVE
Street 315 N FIRST AVE
City EVANSVILLE
State IN
ZIP 47710
Phone 812 450-4066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director SCOTT ULOTH

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