18D0322374 CLIA NUMBER - EPHRAIM MCDOWELL DEDMAN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 18D0322374
  • Facility Name: EPHRAIM MCDOWELL DEDMAN PRIMARY CARE
  • Facility Address: 466 LINDEN AVE
    HARRODSBURG, KY
    ZIP 40330
  • Facility Phone: 859 734-5173
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MR. TIM LANE
  • NPI Number: 1992229231
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D0322374
LAB Type Physician Office
Facility Name EPHRAIM MCDOWELL DEDMAN PRIMARY CARE
Street 466 LINDEN AVE
City HARRODSBURG
State KY
ZIP 40330
Phone 859 734-5173
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2023
Certificate Expiration Date 11/30/2025
Facility Type Physician Office
Lab Director MR. TIM LANE

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