CLIA lab
CLIA 15D0696053: Memorial Hospital Ambulance Service
Jasper, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D0696053 belongs to Memorial Hospital Ambulance Service in Jasper, IN.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 18, 1993
- Facility type
- Ambulance
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 15D0696053
- Lab name
- Memorial Hospital Ambulance Service
- Address
- 800 W 9th St, Jasper, IN 47546
- Phone
- (812) 996-0399
- Fax
- (812) 996-7394
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Ann Paterson MDCertificate for Provider-Performed Microscopy Procedures, Physician office15D0961884
- Brookside Village Health & Living CenterCertificate of Waiver, Skilled nursing or nursing facility15D0999958
- Careatc Kimball International Health CenterCertificate of Waiver, Other15D2167850
- Cathedral Heatlh Care CenterCertificate of Waiver, Skilled nursing or nursing facility15D0894839
- Commonwealth Pain & SpineCertificate of Waiver, Physician office15D2150415
- DBA Serenity Spring Senior Living at NorthwoodCertificate of Waiver, Skilled nursing or nursing facility15D0361051
- DC Family Medicine Dorbett StreetCertificate for Provider-Performed Microscopy Procedures, Physician office15D2350359
- DC Jasper Family MedicineCertificate for Provider-Performed Microscopy Procedures, Physician office15D0940633
- DC Jasper PediatricsCertificate of Waiver, Physician office15D0361024
Related
Questions
What is the CLIA number for Memorial Hospital Ambulance Service in Jasper?
15D0696053, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Memorial Hospital Ambulance Service hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D0696053 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.