18D2009450 CLIA NUMBER - ST ELIZABETH HEALTHCARE MEDICATION MANAGEMENT CLINIC

Laboratory Demographics

  • CLIA Code: 18D2009450
  • Facility Name: ST ELIZABETH HEALTHCARE MEDICATION MANAGEMENT CLINIC
  • Facility Address: 20 MEDICAL VILLAGE DRIVE, SUITE 103
    EDGEWOOD, KY
    ZIP 41017
  • Facility Phone: 859 301-6790
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: MS. KATELYN BELL
  • NPI Number: 1346515491
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2009450
LAB Type Other - CLINIC
Facility Name ST ELIZABETH HEALTHCARE MEDICATION MANAGEMENT CLINIC
Street 20 MEDICAL VILLAGE DRIVE, SUITE 103
City EDGEWOOD
State KY
ZIP 41017
Phone 859 301-6790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Other - CLINIC
Lab Director MS. KATELYN BELL

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