18D1045068 CLIA NUMBER - MADISONVILLE CBOC

Laboratory Demographics

  • CLIA Code: 18D1045068
  • Facility Name: MADISONVILLE CBOC
  • Facility Address: 99 STAGECOACH ROAD
    MADISONVILLE, KY
    ZIP 42431
  • Facility Phone: 270 322-8019
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: DON R. DOMENICO
  • NPI Number: 1790728046
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D1045068
LAB Type Community Clinic
Facility Name MADISONVILLE CBOC
Street 99 STAGECOACH ROAD
City MADISONVILLE
State KY
ZIP 42431
Phone 270 322-8019
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/6/2005
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director DON R. DOMENICO

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