18D0875591 CLIA NUMBER - PADUCAH DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 18D0875591
  • Facility Name: PADUCAH DERMATOLOGY
  • Facility Address: 3101 PARISA DRIVE
    PADUCAH, KY
    ZIP 42003
  • Facility Phone: 270 444-8477
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JOSEPH BLACKMON
  • NPI Number: 1831242551
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 18D0875591
LAB Type Physician Office
Facility Name PADUCAH DERMATOLOGY
Street 3101 PARISA DRIVE
City PADUCAH
State KY
ZIP 42003
Phone 270 444-8477
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/27/2024
Certificate Expiration Date 11/26/2026
Facility Type Physician Office
Lab Director DR. JOSEPH BLACKMON

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