18D1100811 CLIA NUMBER - KENTUCKY RIVER CLINICS

Laboratory Demographics

  • CLIA Code: 18D1100811
  • Facility Name: KENTUCKY RIVER CLINICS
  • Facility Address: 424 JETT DRIVE
    JACKSON, KY
    ZIP 41339
  • Facility Phone: 606 666-6611
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MS. REBECCA HOLBROOK-WATKINS
  • NPI Number: 1174752356
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 18D1100811
LAB Type Rural Health Clinic
Facility Name KENTUCKY RIVER CLINICS
Street 424 JETT DRIVE
City JACKSON
State KY
ZIP 41339
Phone 606 666-6611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Rural Health Clinic
Lab Director MS. REBECCA HOLBROOK-WATKINS

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