18D1007441 CLIA NUMBER - PENNYROYAL HOSPICE

Laboratory Demographics

  • CLIA Code: 18D1007441
  • Facility Name: PENNYROYAL HOSPICE
  • Facility Address: 220 BURLEY AVENUE
    HOPKINSVILLE, KY
    ZIP 42240
  • Facility Phone: 270 885-6428
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: KELLY R. MARTIN
  • NPI Number: 1487626776
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 18D1007441
LAB Type Hospice
Facility Name PENNYROYAL HOSPICE
Street 220 BURLEY AVENUE
City HOPKINSVILLE
State KY
ZIP 42240
Phone 270 885-6428
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Hospice
Lab Director KELLY R. MARTIN

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