18D0325847 CLIA NUMBER - GCG - BOWLING GREEN MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 18D0325847
  • Facility Name: GCG - BOWLING GREEN MEDICAL CLINIC
  • Facility Address: 1777 ASHLEY CIRCLE
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 781-4090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. SELENA KING
  • NPI Number: 1427267368
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D0325847
LAB Type Physician Office
Facility Name GCG - BOWLING GREEN MEDICAL CLINIC
Street 1777 ASHLEY CIRCLE
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 781-4090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Physician Office
Lab Director MS. SELENA KING

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