18D0983198 CLIA NUMBER - VITAL SKIN MEDICAL GROUP PLLC - DBA BARDSTOWN DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 18D0983198
  • Facility Name: VITAL SKIN MEDICAL GROUP PLLC - DBA BARDSTOWN DERMATOLOGY
  • Facility Address: 114 MANOR DRIVE
    BARDSTOWN, KY
    ZIP 40004
  • Facility Phone: 502 317-1140
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. KELLI W. MORGAN
  • NPI Number: 1932260783
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 18D0983198
LAB Type Physician Office
Facility Name VITAL SKIN MEDICAL GROUP PLLC - DBA BARDSTOWN DERMATOLOGY
Street 114 MANOR DRIVE
City BARDSTOWN
State KY
ZIP 40004
Phone 502 317-1140
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Physician Office
Lab Director DR. KELLI W. MORGAN

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