18D1082554 CLIA NUMBER - MARSHALL COUNTY SURGICAL & MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 18D1082554
  • Facility Name: MARSHALL COUNTY SURGICAL & MEDICAL GROUP
  • Facility Address: 617 OLD SYMSONIA ROAD
    BENTON, KY
    ZIP 42025
  • Facility Phone: 270 527-2411
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JULIA LYLES
  • NPI Number: 1689778250
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D1082554
LAB Type Physician Office
Facility Name MARSHALL COUNTY SURGICAL & MEDICAL GROUP
Street 617 OLD SYMSONIA ROAD
City BENTON
State KY
ZIP 42025
Phone 270 527-2411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director DR. JULIA LYLES

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