18D2022716 CLIA NUMBER - FAST PACE KENTUCKY PLLC

Laboratory Demographics

  • CLIA Code: 18D2022716
  • Facility Name: FAST PACE KENTUCKY PLLC
  • Facility Address: 1649 W HWY 192 STE 1
    LONDON, KY
    ZIP 40741
  • Facility Phone: 606 330-0055
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. DANA MARTIN
  • NPI Number: 1023379815
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 18D2022716
LAB Type Physician Office
Facility Name FAST PACE KENTUCKY PLLC
Street 1649 W HWY 192 STE 1
City LONDON
State KY
ZIP 40741
Phone 606 330-0055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director MS. DANA MARTIN

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