15D2204248 CLIA NUMBER - SULLIVAN COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 15D2204248
  • Facility Name: SULLIVAN COUNTY HEALTH DEPARTMENT
  • Facility Address: 27 SOUTH MAIN STREET
    SULLIVAN, IN
    ZIP 47882
  • Facility Phone: 812 268-0224
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. GAMBLE
  • NPI Number: 1285363267
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2204248
LAB Type Public Health Laboratories
Facility Name SULLIVAN COUNTY HEALTH DEPARTMENT
Street 27 SOUTH MAIN STREET
City SULLIVAN
State IN
ZIP 47882
Phone 812 268-0224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Public Health Laboratories
Lab Director MICHAEL J. GAMBLE

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