18D0917461 CLIA NUMBER - CHARLES A MOORE MD

Laboratory Demographics

  • CLIA Code: 18D0917461
  • Facility Name: CHARLES A MOORE MD
  • Facility Address: 123 NORTH 19TH STREET
    MIDDLESBORO, KY
    ZIP 40965
  • Facility Phone: 606 248-0090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHARLES A. MOORE
  • NPI Number: 1003816372
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D0917461
LAB Type Physician Office
Facility Name CHARLES A MOORE MD
Street 123 NORTH 19TH STREET
City MIDDLESBORO
State KY
ZIP 40965
Phone 606 248-0090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director DR. CHARLES A. MOORE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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