18D1064940 CLIA NUMBER - MCMD, PSC

Laboratory Demographics

  • CLIA Code: 18D1064940
  • Facility Name: MCMD, PSC
  • Facility Address: 1340 ELLIS PLACE
    BOWLING GREEN, KY
    ZIP 42101
  • Facility Phone: 270 782-6362
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. COLLINS
  • NPI Number: 1740407667
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D1064940
LAB Type Practitioner Other
Facility Name MCMD, PSC
Street 1340 ELLIS PLACE
City BOWLING GREEN
State KY
ZIP 42101
Phone 270 782-6362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Practitioner Other
Lab Director MICHAEL J. COLLINS

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