18D0326168 CLIA NUMBER - MCH PRIMARY CARE RUSSELLVILLE

Laboratory Demographics

  • CLIA Code: 18D0326168
  • Facility Name: MCH PRIMARY CARE RUSSELLVILLE
  • Facility Address: 1719 NASHVILLE STREET
    RUSSELLVILLE, KY
    ZIP 42276
  • Facility Phone: 270 726-7664
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. PATRICK K. HAYDEN
  • NPI Number: 1699447169
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D0326168
LAB Type Physician Office
Facility Name MCH PRIMARY CARE RUSSELLVILLE
Street 1719 NASHVILLE STREET
City RUSSELLVILLE
State KY
ZIP 42276
Phone 270 726-7664
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director DR. PATRICK K. HAYDEN

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