CLIA lab
CLIA 15D2104207: DC Bristow Family Medicine Clinic
Bristow, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D2104207 belongs to DC Bristow Family Medicine Clinic in Bristow, IN.
Certificate of Waiver, effective September 9, 2025, expires September 8, 2027.
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 9, 2025
- Certificate expiration
- September 8, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 30, 2015
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- 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
- 15D2104207
- Lab name
- DC Bristow Family Medicine Clinic
- Address
- 26020 State Rd 145, Bristow, IN 47515
- Phone
- (812) 357-2099
- Fax
- (812) 996-7085
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for DC Bristow Family Medicine Clinic in Bristow?
15D2104207, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does DC Bristow Family Medicine Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D2104207 expire?
The CMS file lists September 8, 2027 as the certificate expiration date; the certificate took effect September 9, 2025.