15D2182723 CLIA NUMBER - PASSPORT HEALTH - EVANSVILLE

Laboratory Demographics

  • CLIA Code: 15D2182723
  • Facility Name: PASSPORT HEALTH - EVANSVILLE
  • Facility Address: 101 PLAZA EAST BLVD - SUITE 107
    EVANSVILLE, IN
    ZIP 47715
  • Facility Phone: 812 402-6000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. HOWARD BIALICK
  • NPI Number: 1477993939
  • Taxonomy: 163W00000X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 15D2182723
LAB Type Physician Office
Facility Name PASSPORT HEALTH - EVANSVILLE
Street 101 PLAZA EAST BLVD - SUITE 107
City EVANSVILLE
State IN
ZIP 47715
Phone 812 402-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Physician Office
Lab Director DR. HOWARD BIALICK

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