15D2309071 CLIA NUMBER - MONROE COUNTY HEALTH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 15D2309071
  • Facility Name: MONROE COUNTY HEALTH AND WELLNESS
  • Facility Address: 119 W 7TH ST STE 103
    BLOOMINGTON, IN
    ZIP 47404
  • Facility Phone: 864 501-0751
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DANA WALDEN
  • NPI Number: 1306147236
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2309071
LAB Type Practitioner Other
Facility Name MONROE COUNTY HEALTH AND WELLNESS
Street 119 W 7TH ST STE 103
City BLOOMINGTON
State IN
ZIP 47404
Phone 864 501-0751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Practitioner Other
Lab Director DANA WALDEN

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