18D1080801 CLIA NUMBER - BARDSTOWN PEDIATRICS

Laboratory Demographics

CLIA Number: 18D1080801

Facility Name: BARDSTOWN PEDIATRICS

Facility Address:
118 PATRIOT DR STE 204
BARDSTOWN, KY
ZIP 40004
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Facility Phone Number: 270 300-3161

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013443894

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	18D1080801
LAB Type	Physician Office
Facility Name	BARDSTOWN PEDIATRICS
Street	118 PATRIOT DR STE 204
City	BARDSTOWN
State	KY
ZIP	40004
Phone	270 300-3161
CertificateType	4
CertificateEffectiveDate	10/29/2023
CertificateExpirationDate	10/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024