18D0322304 CLIA NUMBER - JEFFERSONTOWN REHABILITATION

Laboratory Demographics

  • CLIA Code: 18D0322304
  • Facility Name: JEFFERSONTOWN REHABILITATION
  • Facility Address: 3500 GOOD SAMARITAN WAY
    JEFFERSONTOWN, KY
    ZIP 40299
  • Facility Phone: 502 267-7403
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. OSAWARN OMARUYI
  • NPI Number: 1629575295
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 18D0322304
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name JEFFERSONTOWN REHABILITATION
Street 3500 GOOD SAMARITAN WAY
City JEFFERSONTOWN
State KY
ZIP 40299
Phone 502 267-7403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. OSAWARN OMARUYI

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