15D2297694 CLIA NUMBER - GEORGETOWN MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 15D2297694
  • Facility Name: GEORGETOWN MEDICAL CENTER
  • Facility Address: 5300 STATE ROAD 64 SUITE 101
    GEORGETOWN, IN
    ZIP 47122
  • Facility Phone: 812 501-5151
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN KIRKMAN
  • NPI Number: 1770828220
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 15D2297694
LAB Type Physician Office
Facility Name GEORGETOWN MEDICAL CENTER
Street 5300 STATE ROAD 64 SUITE 101
City GEORGETOWN
State IN
ZIP 47122
Phone 812 501-5151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Physician Office
Lab Director STEPHEN KIRKMAN

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