18D0874040 CLIA NUMBER - MARTIN COUNTY HEALTHCARE FACILITY

Laboratory Demographics

CLIA Number: 18D0874040

Facility Name: MARTIN COUNTY HEALTHCARE FACILITY

Facility Address:
62 MAUDE ROAD
INEZ, KY
ZIP 41224
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Facility Phone Number: 606 298-0091

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1316363112

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D0874040
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	MARTIN COUNTY HEALTHCARE FACILITY
Street	62 MAUDE ROAD
City	INEZ
State	KY
ZIP	41224
Phone	606 298-0091
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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