18D2006829 CLIA NUMBER - WESTERN KENTUCKY DIAGNOSTIC IMAGING

Laboratory Demographics

  • CLIA Code: 18D2006829
  • Facility Name: WESTERN KENTUCKY DIAGNOSTIC IMAGING
  • Facility Address: 1635 SCOTTSVILLE ROAD
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 746-9500
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ABDELRAHMAN M. ABDALLA
  • NPI Number: 1679549976
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 18D2006829
LAB Type Practitioner Other
Facility Name WESTERN KENTUCKY DIAGNOSTIC IMAGING
Street 1635 SCOTTSVILLE ROAD
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 746-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Practitioner Other
Lab Director ABDELRAHMAN M. ABDALLA

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