18D0326168 CLIA NUMBER - LOGAN FAMILY PRACTICE LLC

Laboratory Demographics

CLIA Number: 18D0326168

Facility Name: LOGAN FAMILY PRACTICE LLC

Facility Address:
1719 NASHVILLE STREET
RUSSELLVILLE, KY
ZIP 42276
Get Directions

Facility Phone Number: 502 726-7664

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1699447169

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D0326168
LAB Type	Physician Office
Facility Name	LOGAN FAMILY PRACTICE LLC
Street	1719 NASHVILLE STREET
City	RUSSELLVILLE
State	KY
ZIP	42276
Phone	502 726-7664
CertificateType	3
CertificateEffectiveDate	9/2/2022
CertificateExpirationDate	9/1/2024
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024