18D0873964 CLIA NUMBER - OWENSBORO HEALTH MEDICAL GROUP CARDIOLOGY

Laboratory Demographics

CLIA Number: 18D0873964

Facility Name: OWENSBORO HEALTH MEDICAL GROUP CARDIOLOGY

Facility Address:
1301 PLEASANT VALLEY ROAD, SUITE 202
OWENSBORO, KY
ZIP 42303
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Facility Phone Number: 270 417-7500

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1457749582

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	18D0873964
LAB Type	Physician Office
Facility Name	OWENSBORO HEALTH MEDICAL GROUP CARDIOLOGY
Street	1301 PLEASANT VALLEY ROAD, SUITE 202
City	OWENSBORO
State	KY
ZIP	42303
Phone	270 417-7500
CertificateType	4
CertificateEffectiveDate	7/25/2022
CertificateExpirationDate	7/24/2024
FacilityType	Waiver

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