15D2276959 CLIA NUMBER - BOONE COUNTY JAIL

Laboratory Demographics

  • CLIA Code: 15D2276959
  • Facility Name: BOONE COUNTY JAIL
  • Facility Address: 1905 INDIANAPOLIS AVE
    LEBANON, IN
    ZIP 46052
  • Facility Phone: 423 206-2002
  • Facility Type: Other - JAIL MEDICAL UNIT
  • Facility Type: Waiver
  • Lab Director: TONYA POWELL
  • NPI Number: 1447326814
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 15D2276959
LAB Type Other - JAIL MEDICAL UNIT
Facility Name BOONE COUNTY JAIL
Street 1905 INDIANAPOLIS AVE
City LEBANON
State IN
ZIP 46052
Phone 423 206-2002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Other - JAIL MEDICAL UNIT
Lab Director TONYA POWELL

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