05D0569343 CLIA NUMBER - WAYNE L IVERSON MD

Laboratory Demographics

  • CLIA Code: 05D0569343
  • Facility Name: WAYNE L IVERSON MD
  • Facility Address: 16 WINCHESTER PLAZA
    WINCHESTER, KY
    ZIP 40391
  • Facility Phone: 859 513-0078
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WAYNE L. IVERSON
  • NPI Number: 1447397906
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0569343
LAB Type Physician Office
Facility Name WAYNE L IVERSON MD
Street 16 WINCHESTER PLAZA
City WINCHESTER
State KY
ZIP 40391
Phone 859 513-0078
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director DR. WAYNE L. IVERSON

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