18D0968439 CLIA NUMBER - FORT LOGAN WALK-IN & PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 18D0968439
  • Facility Name: FORT LOGAN WALK-IN & PRIMARY CARE
  • Facility Address: 110 METKER TRAIL
    STANFORD, KY
    ZIP 40484
  • Facility Phone: 606 365-3360
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MS. GAIL SMOTHERS
  • NPI Number: 1396295390
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 18D0968439
LAB Type Community Clinic
Facility Name FORT LOGAN WALK-IN & PRIMARY CARE
Street 110 METKER TRAIL
City STANFORD
State KY
ZIP 40484
Phone 606 365-3360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Community Clinic
Lab Director MS. GAIL SMOTHERS

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