18D2037289 CLIA NUMBER - PENNYROYAL CENTER MADISONVILLE CLINIC

Laboratory Demographics

  • CLIA Code: 18D2037289
  • Facility Name: PENNYROYAL CENTER MADISONVILLE CLINIC
  • Facility Address: 200 CLINIC DRIVE, 7TH FLOOR
    MADISONVILLE, KY
    ZIP 42431
  • Facility Phone: 270 821-8874
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MR. ERIC EMBRY
  • NPI Number: 1346321643
  • Taxonomy: 251C00000X - Day Training, Developmentally Disabled Services

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CLIA Record

Field Name Field Value
CLIA Number 18D2037289
LAB Type Community Clinic
Facility Name PENNYROYAL CENTER MADISONVILLE CLINIC
Street 200 CLINIC DRIVE, 7TH FLOOR
City MADISONVILLE
State KY
ZIP 42431
Phone 270 821-8874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Community Clinic
Lab Director MR. ERIC EMBRY

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