18D1091575 CLIA NUMBER - UNIVERSITY OF KENTUCKY COMMUNITY PEDIATRIC CARDIOLOGY

Laboratory Demographics

CLIA Number: 18D1091575

Facility Name: UNIVERSITY OF KENTUCKY COMMUNITY PEDIATRIC CARDIOLOGY

Facility Address:
1760 NICHILASVILLE ROAD, SUITE 602
LEXINGTON, KY
ZIP 40503
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Facility Phone Number: 859 218-5244

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1295190833

Taxonomy: 3336S0011X - Pharmacy
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

CLIA Record

Field Name	Field Value
CLIA Number	18D1091575
LAB Type	Physician Office
Facility Name	UNIVERSITY OF KENTUCKY COMMUNITY PEDIATRIC CARDIOLOGY
Street	1760 NICHILASVILLE ROAD, SUITE 602
City	LEXINGTON
State	KY
ZIP	40503
Phone	859 218-5244
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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