15D2196178 CLIA NUMBER - MADISON DIRECT HEALTH

Laboratory Demographics

  • CLIA Code: 15D2196178
  • Facility Name: MADISON DIRECT HEALTH
  • Facility Address: 110 HOLT DRIVE
    MADISON, IN
    ZIP 47250
  • Facility Phone: 812 265-2500
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BRANDY J. SMITH
  • NPI Number: 1013513282
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2196178
LAB Type Practitioner Other
Facility Name MADISON DIRECT HEALTH
Street 110 HOLT DRIVE
City MADISON
State IN
ZIP 47250
Phone 812 265-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2024
Certificate Expiration Date 10/14/2026
Facility Type Practitioner Other
Lab Director BRANDY J. SMITH

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