18D1000308 CLIA NUMBER - TIM LONG MD PSC

Laboratory Demographics

  • CLIA Code: 18D1000308
  • Facility Name: TIM LONG MD PSC
  • Facility Address: 1320 ANDREA STREET
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 746-5455
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIM LONG
  • NPI Number: 1417057902
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D1000308
LAB Type Physician Office
Facility Name TIM LONG MD PSC
Street 1320 ANDREA STREET
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 746-5455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2024
Certificate Expiration Date 3/7/2026
Facility Type Physician Office
Lab Director TIM LONG

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