15D2215179 CLIA NUMBER - DEACONESS CLINIC MEMORIAL

Laboratory Demographics

  • CLIA Code: 15D2215179
  • Facility Name: DEACONESS CLINIC MEMORIAL
  • Facility Address: 645 CONNIE ROBINSON WAY
    EVANSVILLE, IN
    ZIP 47713
  • Facility Phone: 812 450-8764
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PEARL QUARTEY
  • NPI Number: 1013519396
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2215179
LAB Type Physician Office
Facility Name DEACONESS CLINIC MEMORIAL
Street 645 CONNIE ROBINSON WAY
City EVANSVILLE
State IN
ZIP 47713
Phone 812 450-8764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Physician Office
Lab Director DR. PEARL QUARTEY

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