18D1052890 CLIA NUMBER - LAKE CUMBERLAND PHYSICIAN PRACTICES

Laboratory Demographics

  • CLIA Code: 18D1052890
  • Facility Name: LAKE CUMBERLAND PHYSICIAN PRACTICES
  • Facility Address: 401 BOGLE STREET, SUITE 101
    SOMERSET, KY
    ZIP 42503
  • Facility Phone: 606 676-0275
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. N MULLAI
  • NPI Number: 1124441274
  • Taxonomy: 207RH0003X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D1052890
LAB Type Physician Office
Facility Name LAKE CUMBERLAND PHYSICIAN PRACTICES
Street 401 BOGLE STREET, SUITE 101
City SOMERSET
State KY
ZIP 42503
Phone 606 676-0275
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director DR. N MULLAI

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