18D1090690 CLIA NUMBER - T J HEALTH COLUMBIA CLINIC

Laboratory Demographics

  • CLIA Code: 18D1090690
  • Facility Name: T J HEALTH COLUMBIA CLINIC
  • Facility Address: 902 WELLNESS WAY
    COLUMBIA, KY
    ZIP 42728
  • Facility Phone: 270 384-0451
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. CLINTON KITECK
  • NPI Number: 1235595653
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D1090690
LAB Type Rural Health Clinic
Facility Name T J HEALTH COLUMBIA CLINIC
Street 902 WELLNESS WAY
City COLUMBIA
State KY
ZIP 42728
Phone 270 384-0451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Rural Health Clinic
Lab Director DR. CLINTON KITECK

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This page was last updated on: 6/4/2025