15D2208667 CLIA NUMBER - LANDMARK SURGICAL SUITES, LLC

Laboratory Demographics

  • CLIA Code: 15D2208667
  • Facility Name: LANDMARK SURGICAL SUITES, LLC
  • Facility Address: 2990 GOTTBRATH PARKWAY
    JEFFERSONVILLE, IN
    ZIP 47130
  • Facility Phone: 502 553-4999
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TRAVIS CLEGG
  • NPI Number: 1902401748
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2208667
LAB Type Ambulatory Surgery Center
Facility Name LANDMARK SURGICAL SUITES, LLC
Street 2990 GOTTBRATH PARKWAY
City JEFFERSONVILLE
State IN
ZIP 47130
Phone 502 553-4999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Ambulatory Surgery Center
Lab Director TRAVIS CLEGG

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