18D1036584 CLIA NUMBER - WILLIAM H FULLER MEMORIAL SERVICES CENTER

Laboratory Demographics

  • CLIA Code: 18D1036584
  • Facility Name: WILLIAM H FULLER MEMORIAL SERVICES CENTER
  • Facility Address: 1525 CUBA ROAD
    MAYFIELD, KY
    ZIP 42066
  • Facility Phone: 270 247-2588
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MR. TERRY HUDSPETH
  • NPI Number: 1841650975
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 18D1036584
LAB Type Other
Facility Name WILLIAM H FULLER MEMORIAL SERVICES CENTER
Street 1525 CUBA ROAD
City MAYFIELD
State KY
ZIP 42066
Phone 270 247-2588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Other
Lab Director MR. TERRY HUDSPETH

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