15D2309927 CLIA NUMBER - VALLEY PROFESSIONAL TERRE HAUTE NORTH SCHOOL

Laboratory Demographics

  • CLIA Code: 15D2309927
  • Facility Name: VALLEY PROFESSIONAL TERRE HAUTE NORTH SCHOOL
  • Facility Address: 3434 MAPLE AVE
    TERRE HAUTE, IN
    ZIP 47802
  • Facility Phone: 765 592-6164
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DANIELLE CUNDIFF
  • NPI Number: 1962085449
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2309927
LAB Type Federally Qualified Health Center
Facility Name VALLEY PROFESSIONAL TERRE HAUTE NORTH SCHOOL
Street 3434 MAPLE AVE
City TERRE HAUTE
State IN
ZIP 47802
Phone 765 592-6164
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Federally Qualified Health Center
Lab Director DANIELLE CUNDIFF

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This page was last updated on: 6/4/2025