18D1106021 CLIA NUMBER - 12TH STREET COVINGTON DIALYSIS

Laboratory Demographics

  • CLIA Code: 18D1106021
  • Facility Name: 12TH STREET COVINGTON DIALYSIS
  • Facility Address: 1500 JAMES SIMPSON JR WAY SUITE 1100
    COVINGTON, KY
    ZIP 41011
  • Facility Phone: 859 261-4345
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ISAAC P. THOMAS
  • NPI Number: 1255566444
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D1106021
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name 12TH STREET COVINGTON DIALYSIS
Street 1500 JAMES SIMPSON JR WAY SUITE 1100
City COVINGTON
State KY
ZIP 41011
Phone 859 261-4345
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2025
Certificate Expiration Date 10/1/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ISAAC P. THOMAS

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