DEACONESS CLINIC, INC
NPI 1174026363
Clinic/Center in Boonville, IN
- Organization
- Clinic/Center
- CLIA Number: 15D2144696
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-20-2028
About DEACONESS CLINIC, INC
This page provides the complete NPI Profile along with additional information for Deaconess Clinic, Inc, a provider established in Boonville, Indiana operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1174026363 assigned on March 2018. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Cheryl Annette Wathen (Cfo)
- NPI
- 1174026363 Verify this NPI
- Provider Name
- DEACONESS CLINIC, INC
- Entity Type
- Organization
- Location Address
- 930 W MAIN ST BOONVILLE, IN 47601
- Location Phone
- (812) 641-0088
- Location Fax
- (812) 641-0092
- Mailing Address
- PO BOX 1510 EVANSVILLE, IN 47706
- Mailing Phone
- (812) 641-0088
- Mailing Fax
- (812) 641-0092
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-14-2018
- Last Update Date
- 03-14-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2144696
- Facility Type
- Physician Office
- Certificate Effective Date
- February 21, 2026
- Certificate Expiration Date
- February 20, 2028
- Laboratory Director
- SCOTT ULOTH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Deaconess Clinic, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174026363, enumerated as an "organization" on March 14, 2018.
The provider is located at 930 W MAIN ST BOONVILLE, IN 47601 and the phone number is (812) 641-0088.
Clinic/Center with taxonomy code 261Q00000X.
