18D0718307 CLIA NUMBER - ROBERT E ELLIS MD

Laboratory Demographics

  • CLIA Code: 18D0718307
  • Facility Name: ROBERT E ELLIS MD
  • Facility Address: 9115 LEESGATE RD SUITE C
    LOUISVILLE, KY
    ZIP 40222
  • Facility Phone: 502 719-0782
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT E. ELLIS
  • NPI Number: 1427006816
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D0718307
LAB Type Physician Office
Facility Name ROBERT E ELLIS MD
Street 9115 LEESGATE RD SUITE C
City LOUISVILLE
State KY
ZIP 40222
Phone 502 719-0782
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 Physician Office
Lab Director ROBERT E. ELLIS

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