15D2182074 CLIA NUMBER - PROACTIVE MD DELPHI

Laboratory Demographics

  • CLIA Code: 15D2182074
  • Facility Name: PROACTIVE MD DELPHI
  • Facility Address: 303 W VINE ST
    DELPHI, IN
    ZIP 46923
  • Facility Phone: 574 297-5527
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MISTY WOOLEVER
  • NPI Number: 1366169237
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2182074
LAB Type Physician Office
Facility Name PROACTIVE MD DELPHI
Street 303 W VINE ST
City DELPHI
State IN
ZIP 46923
Phone 574 297-5527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Physician Office
Lab Director MISTY WOOLEVER

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