18D0895458 CLIA NUMBER - JEROME A DIXON DO PSC

Laboratory Demographics

  • CLIA Code: 18D0895458
  • Facility Name: JEROME A DIXON DO PSC
  • Facility Address: 150 WEST BEAR TRACK ROAD
    CAMPBELLSVILLE, KY
    ZIP 42718
  • Facility Phone: 270 465-8133
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JEROME A. DIXON DO
  • NPI Number: 1215919451
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D0895458
LAB Type Physician Office
Facility Name JEROME A DIXON DO PSC
Street 150 WEST BEAR TRACK ROAD
City CAMPBELLSVILLE
State KY
ZIP 42718
Phone 270 465-8133
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director DR. JEROME A. DIXON DO

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