15D2275439 CLIA NUMBER - UAP CLINIC, LLC

Laboratory Demographics

CLIA Number: 15D2275439

Facility Name: UAP CLINIC, LLC

Facility Address:
1429 N 6TH STREET ST, MEDICAL OFFICE BUILDING
TERRE HAUTE, IN
ZIP 47807
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Facility Phone Number: 812 231-6840

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1457366098

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	15D2275439
LAB Type	Physician Office
Facility Name	UAP CLINIC, LLC
Street	1429 N 6TH STREET ST, MEDICAL OFFICE BUILDING
City	TERRE HAUTE
State	IN
ZIP	47807
Phone	812 231-6840
CertificateType	3
CertificateEffectiveDate	1/23/2023
CertificateExpirationDate	1/22/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024