18D0325025 CLIA NUMBER - CRIDER JOHNSON PEDIATRICS

Laboratory Demographics

  • CLIA Code: 18D0325025
  • Facility Name: CRIDER JOHNSON PEDIATRICS
  • Facility Address: 387 TOWN MOUNTAIN ROAD, SUITE 202
    PIKEVILLE, KY
    ZIP 41502
  • Facility Phone: 606 437-1008
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MR. STAN M. JOHNSON
  • NPI Number: 1114029212
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 18D0325025
LAB Type Physician Office
Facility Name CRIDER JOHNSON PEDIATRICS
Street 387 TOWN MOUNTAIN ROAD, SUITE 202
City PIKEVILLE
State KY
ZIP 41502
Phone 606 437-1008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director MR. STAN M. JOHNSON

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