15D2275450 CLIA NUMBER - SOUTHERN INDIANA CLINICAL TRIALS

Laboratory Demographics

  • CLIA Code: 15D2275450
  • Facility Name: SOUTHERN INDIANA CLINICAL TRIALS
  • Facility Address: 1813 STATE STREET SUITE 200
    NEW ALBANY, IN
    ZIP 47150
  • Facility Phone: 502 396-4109
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LEE MISTY HUMPHRESS
  • NPI Number: 1831110170
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2275450
LAB Type Practitioner Other
Facility Name SOUTHERN INDIANA CLINICAL TRIALS
Street 1813 STATE STREET SUITE 200
City NEW ALBANY
State IN
ZIP 47150
Phone 502 396-4109
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2025
Certificate Expiration Date 1/22/2027
Facility Type Practitioner Other
Lab Director LEE MISTY HUMPHRESS

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This page was last updated on: 3/20/2025