18D1068675 CLIA NUMBER - PADUCAH RETINAL CENTER

Laboratory Demographics

  • CLIA Code: 18D1068675
  • Facility Name: PADUCAH RETINAL CENTER
  • Facility Address: 4630 VILLAGE SQUARE DRIVE
    PADUCAH, KY
    ZIP 42001
  • Facility Phone: 270 443-4393
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARL W. BAKER
  • NPI Number: 1194777284
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 18D1068675
LAB Type Physician Office
Facility Name PADUCAH RETINAL CENTER
Street 4630 VILLAGE SQUARE DRIVE
City PADUCAH
State KY
ZIP 42001
Phone 270 443-4393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director CARL W. BAKER

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