15D2269966 CLIA NUMBER - EVERNORTH HEALTH COACH-WHITESTOWN

Laboratory Demographics

  • CLIA Code: 15D2269966
  • Facility Name: EVERNORTH HEALTH COACH-WHITESTOWN
  • Facility Address: 4750 E 450 SOUTH
    WHITESTOWN, IN
    ZIP 46075
  • Facility Phone: 480 868-0646
  • Facility Type: Other - OUT PATIENT
  • Facility Type: Waiver
  • Lab Director: KELLY HULL
  • NPI Number: 1932980190
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2269966
LAB Type Other - OUT PATIENT
Facility Name EVERNORTH HEALTH COACH-WHITESTOWN
Street 4750 E 450 SOUTH
City WHITESTOWN
State IN
ZIP 46075
Phone 480 868-0646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Other - OUT PATIENT
Lab Director KELLY HULL

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