18D0712190 CLIA NUMBER - LINCOLN TRAIL BEHAVIORAL HEALTH SYSTEM

Laboratory Demographics

  • CLIA Code: 18D0712190
  • Facility Name: LINCOLN TRAIL BEHAVIORAL HEALTH SYSTEM
  • Facility Address: 3909 SOUTH WILSON ROAD
    RADCLIFF, KY
    ZIP 40160
  • Facility Phone: 502 351-9444
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MR. KYLE M. FORTUNE
  • NPI Number: 1750356986
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D0712190
LAB Type Independent
Facility Name LINCOLN TRAIL BEHAVIORAL HEALTH SYSTEM
Street 3909 SOUTH WILSON ROAD
City RADCLIFF
State KY
ZIP 40160
Phone 502 351-9444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Independent
Lab Director MR. KYLE M. FORTUNE

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This page was last updated on: 6/4/2025