18D0712516 CLIA NUMBER - DENISE T DICKINSON MD

Laboratory Demographics

  • CLIA Code: 18D0712516
  • Facility Name: DENISE T DICKINSON MD
  • Facility Address: 1700 BLUEGRASS AVE STE 300
    LOUISVILLE, KY
    ZIP 40215
  • Facility Phone: 502 366-1388
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DENISE T. DICKINSON
  • NPI Number: 1831267459
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 18D0712516
LAB Type Physician Office
Facility Name DENISE T DICKINSON MD
Street 1700 BLUEGRASS AVE STE 300
City LOUISVILLE
State KY
ZIP 40215
Phone 502 366-1388
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 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type Physician Office
Lab Director DENISE T. DICKINSON

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