18D2030174 CLIA NUMBER - CARRICO CONGLETON FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 18D2030174
  • Facility Name: CARRICO CONGLETON FAMILY PRACTICE
  • Facility Address: 2811 NEW HARTFORD ROAD, STE B
    OWENSBORO, KY
    ZIP 42303
  • Facility Phone: 270 215-0234
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JUDY A. CARRICO
  • NPI Number: 1750665162
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 18D2030174
LAB Type Practitioner Other
Facility Name CARRICO CONGLETON FAMILY PRACTICE
Street 2811 NEW HARTFORD ROAD, STE B
City OWENSBORO
State KY
ZIP 42303
Phone 270 215-0234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Practitioner Other
Lab Director JUDY A. CARRICO

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