18D0717763 CLIA NUMBER - KENNETH G COOK MD

Laboratory Demographics

CLIA Number: 18D0717763

Facility Name: KENNETH G COOK MD

Facility Address:
225 MEDICAL CENTER DR
PADUCAH, KY
ZIP 42003
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Facility Phone Number: 270 441-4144

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720169501

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	18D0717763
LAB Type	Physician Office
Facility Name	KENNETH G COOK MD
Street	225 MEDICAL CENTER DR
City	PADUCAH
State	KY
ZIP	42003
Phone	270 441-4144
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024