15D2233891 CLIA NUMBER - WABASH VALLEY DERMATOLOGY & MEDSPA

Laboratory Demographics

  • CLIA Code: 15D2233891
  • Facility Name: WABASH VALLEY DERMATOLOGY & MEDSPA
  • Facility Address: 1208 E CANVASBACK DR
    TERRE HAUTE, IN
    ZIP 47802
  • Facility Phone: 812 917-7252
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM E. HEATH
  • NPI Number: 1811223944
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 15D2233891
LAB Type Practitioner Other
Facility Name WABASH VALLEY DERMATOLOGY & MEDSPA
Street 1208 E CANVASBACK DR
City TERRE HAUTE
State IN
ZIP 47802
Phone 812 917-7252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Practitioner Other
Lab Director DR. WILLIAM E. HEATH

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