18D0947470 CLIA NUMBER - SAM KESRI MD

Laboratory Demographics

  • CLIA Code: 18D0947470
  • Facility Name: SAM KESRI MD
  • Facility Address: 6040 SCOTTSVILLE ROAD
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 842-5850
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAM KESRI
  • NPI Number: 1477571925
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D0947470
LAB Type Physician Office
Facility Name SAM KESRI MD
Street 6040 SCOTTSVILLE ROAD
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 842-5850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Physician Office
Lab Director SAM KESRI

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