18D1025622 CLIA NUMBER - CHILDREN'S DIABETES AND ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 18D1025622
  • Facility Name: CHILDREN'S DIABETES AND ENDOCRINOLOGY
  • Facility Address: 9720 PARK PLAZA AVENUE, SUITE 202
    LOUISVILLE, KY
    ZIP 40241
  • Facility Phone: 502 327-9703
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSAN RAGHAVAN
  • NPI Number: 1386070019
  • Taxonomy: 2080P0205X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D1025622
LAB Type Physician Office
Facility Name CHILDREN'S DIABETES AND ENDOCRINOLOGY
Street 9720 PARK PLAZA AVENUE, SUITE 202
City LOUISVILLE
State KY
ZIP 40241
Phone 502 327-9703
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Physician Office
Lab Director SUSAN RAGHAVAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025