15D2252361 CLIA NUMBER - VIVERANT INTEGRATIVE CLINIC

Laboratory Demographics

  • CLIA Code: 15D2252361
  • Facility Name: VIVERANT INTEGRATIVE CLINIC
  • Facility Address: 335 SPRING STREET SU B
    JEFFERSONVILLE, IN
    ZIP 47130
  • Facility Phone: 812 725-0950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICKEY D. KINZEY
  • NPI Number: 1255943767
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2252361
LAB Type Physician Office
Facility Name VIVERANT INTEGRATIVE CLINIC
Street 335 SPRING STREET SU B
City JEFFERSONVILLE
State IN
ZIP 47130
Phone 812 725-0950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Physician Office
Lab Director RICKEY D. KINZEY

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