15D2240561 CLIA NUMBER - TERRE HAUTE OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 15D2240561
  • Facility Name: TERRE HAUTE OUTPATIENT CLINIC
  • Facility Address: 5080 EAST BILL FARR DRIVE
    TERRE HAUTE, IN
    ZIP 47803
  • Facility Phone: 317 988-2219
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: CHRISTOPHER WADE
  • NPI Number: 1992475206
  • Taxonomy: 332100000X - Department of Veterans Affairs (VA) Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2240561
LAB Type Community Clinic
Facility Name TERRE HAUTE OUTPATIENT CLINIC
Street 5080 EAST BILL FARR DRIVE
City TERRE HAUTE
State IN
ZIP 47803
Phone 317 988-2219
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/20/2021
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director CHRISTOPHER WADE

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