18D0975398 CLIA NUMBER - CLARK CLINIC FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 18D0975398
  • Facility Name: CLARK CLINIC FAMILY MEDICINE
  • Facility Address: 1520 BOONESBORO ROAD
    WINCHESTER, KY
    ZIP 40391
  • Facility Phone: 859 744-0067
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHELLY ROGERS
  • NPI Number: 1003842501
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D0975398
LAB Type Physician Office
Facility Name CLARK CLINIC FAMILY MEDICINE
Street 1520 BOONESBORO ROAD
City WINCHESTER
State KY
ZIP 40391
Phone 859 744-0067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2024
Certificate Expiration Date 7/6/2026
Facility Type Physician Office
Lab Director DR. SHELLY ROGERS

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This page was last updated on: 6/4/2025