18D1008432 CLIA NUMBER - KENTUCKY MEDICAL SPECIALISTS, PSC

Laboratory Demographics

  • CLIA Code: 18D1008432
  • Facility Name: KENTUCKY MEDICAL SPECIALISTS, PSC
  • Facility Address: 4001 KRESGE WAY, SUITE 236
    LOUISVILLE, KY
    ZIP 40207
  • Facility Phone: 502 893-7372
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MR. MARLON CHAGUA
  • NPI Number: 1730358383
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D1008432
LAB Type Physician Office
Facility Name KENTUCKY MEDICAL SPECIALISTS, PSC
Street 4001 KRESGE WAY, SUITE 236
City LOUISVILLE
State KY
ZIP 40207
Phone 502 893-7372
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Physician Office
Lab Director MR. MARLON CHAGUA

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