18D1102209 CLIA NUMBER - THREE RIVERS MEDICAL CENTER INC

Laboratory Demographics

CLIA Number: 18D1102209

Facility Name: THREE RIVERS MEDICAL CENTER INC

Facility Address:
94 BOARD WALK
INEZ, KY
ZIP 41224
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Facility Phone Number: 606 298-2660

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699038737

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D1102209
LAB Type	Physician Office
Facility Name	THREE RIVERS MEDICAL CENTER INC
Street	94 BOARD WALK
City	INEZ
State	KY
ZIP	41224
Phone	606 298-2660
CertificateType	4
CertificateEffectiveDate	7/14/2023
CertificateExpirationDate	7/13/2025
FacilityType	Waiver

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