18D0980855 CLIA NUMBER - FAYETTE COUNTY DETENTION CENTER MED

Laboratory Demographics

  • CLIA Code: 18D0980855
  • Facility Name: FAYETTE COUNTY DETENTION CENTER MED
  • Facility Address: 600 OLD FRANKFORT CIRCLE
    LEXINGTON, KY
    ZIP 40510
  • Facility Phone: 859 425-2740
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JONATHAN BOWEN
  • NPI Number: 1093143943
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D0980855
LAB Type Rural Health Clinic
Facility Name FAYETTE COUNTY DETENTION CENTER MED
Street 600 OLD FRANKFORT CIRCLE
City LEXINGTON
State KY
ZIP 40510
Phone 859 425-2740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2024
Certificate Expiration Date 12/5/2026
Facility Type Rural Health Clinic
Lab Director JONATHAN BOWEN

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