18D0975290 CLIA NUMBER - JUNIPER HEALTH INC DBA JHI BREATHITT COUNTY FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 18D0975290

Facility Name: JUNIPER HEALTH INC DBA JHI BREATHITT COUNTY FAMILY HEALTH CENTER

Facility Address:
1484 LAKESIDE DRIVE
JACKSON, KY
ZIP 41339
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Facility Phone Number: 606 666-9950

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1467417691

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D0975290
LAB Type	Federally Qualified Health Center
Facility Name	JUNIPER HEALTH INC DBA JHI BREATHITT COUNTY FAMILY HEALTH CENTER
Street	1484 LAKESIDE DRIVE
City	JACKSON
State	KY
ZIP	41339
Phone	606 666-9950
CertificateType	4
CertificateEffectiveDate	2/22/2024
CertificateExpirationDate	2/21/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024