18D1036587 CLIA NUMBER - FOUR RIVERS BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 18D1036587
  • Facility Name: FOUR RIVERS BEHAVIORAL HEALTH
  • Facility Address: 425 BROADWAY, SUITE 102
    PADUCAH, KY
    ZIP 42001
  • Facility Phone: 270 442-7121
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: MR. TERRY HUDSPETH
  • NPI Number: 1508255464
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 18D1036587
LAB Type Comp. Outpatient Rehab Facility
Facility Name FOUR RIVERS BEHAVIORAL HEALTH
Street 425 BROADWAY, SUITE 102
City PADUCAH
State KY
ZIP 42001
Phone 270 442-7121
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 Comp. Outpatient Rehab Facility
Lab Director MR. TERRY HUDSPETH

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