18D0691478 CLIA NUMBER - LEITCHFIELD PEDIATRIC CLINIC PSC

Laboratory Demographics

  • CLIA Code: 18D0691478
  • Facility Name: LEITCHFIELD PEDIATRIC CLINIC PSC
  • Facility Address: 901 WALLACE AVENUE
    LEITCHFIELD, KY
    ZIP 42754
  • Facility Phone: 270 259-5641
  • Facility Type: Rural Health Clinic
  • Facility Type: Certificate of Compliance
  • Lab Director: MR. MATT W. SMITH
  • NPI Number: 1558318543
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D0691478
LAB Type Rural Health Clinic
Facility Name LEITCHFIELD PEDIATRIC CLINIC PSC
Street 901 WALLACE AVENUE
City LEITCHFIELD
State KY
ZIP 42754
Phone 270 259-5641
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Rural Health Clinic
Lab Director MR. MATT W. SMITH

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