15D2251908 CLIA NUMBER - EVANSVILLE ENDOSCOPY SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 15D2251908
  • Facility Name: EVANSVILLE ENDOSCOPY SURGERY CENTER, LLC
  • Facility Address: 3800 VENETIAN WAY
    NEWBURGH, IN
    ZIP 47630
  • Facility Phone: 812 491-2568
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GARDAR GISLASON
  • NPI Number: 1669044111
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2251908
LAB Type Ambulatory Surgery Center
Facility Name EVANSVILLE ENDOSCOPY SURGERY CENTER, LLC
Street 3800 VENETIAN WAY
City NEWBURGH
State IN
ZIP 47630
Phone 812 491-2568
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Ambulatory Surgery Center
Lab Director GARDAR GISLASON

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