18D0692547 CLIA NUMBER - GEORGETOWN INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 18D0692547
  • Facility Name: GEORGETOWN INTERNAL MEDICINE
  • Facility Address: 200 BEVINS LANE, SUITE A
    GEORGETOWN, KY
    ZIP 40324
  • Facility Phone: 502 863-0722
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BENJAMIN P. LYON
  • NPI Number: 1730533209
  • Taxonomy: 363AM0700X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 18D0692547
LAB Type Physician Office
Facility Name GEORGETOWN INTERNAL MEDICINE
Street 200 BEVINS LANE, SUITE A
City GEORGETOWN
State KY
ZIP 40324
Phone 502 863-0722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Physician Office
Lab Director DR. BENJAMIN P. LYON

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