15D2320436 CLIA NUMBER - DEACONESS COMPREHENSIVE PAIN MANAGEMENT - JASPER

Laboratory Demographics

  • CLIA Code: 15D2320436
  • Facility Name: DEACONESS COMPREHENSIVE PAIN MANAGEMENT - JASPER
  • Facility Address: 721 W 13TH STREET, SUITE 102
    JASPER, IN
    ZIP 47546
  • Facility Phone: 812 996-6669
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIA CALDWELL
  • NPI Number: 1679077200
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2320436
LAB Type Physician Office
Facility Name DEACONESS COMPREHENSIVE PAIN MANAGEMENT - JASPER
Street 721 W 13TH STREET, SUITE 102
City JASPER
State IN
ZIP 47546
Phone 812 996-6669
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Physician Office
Lab Director JULIA CALDWELL

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