18D2039683 CLIA NUMBER - AIR -EVAC 108

Laboratory Demographics

  • CLIA Code: 18D2039683
  • Facility Name: AIR -EVAC 108
  • Facility Address: 1113 MEDICAL CENTER DRIVE
    MAYFIELD, KY
    ZIP 42066
  • Facility Phone: 417 274-8328
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: ALLEN JONES
  • NPI Number: 1598021644
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 18D2039683
LAB Type Ambulance
Facility Name AIR -EVAC 108
Street 1113 MEDICAL CENTER DRIVE
City MAYFIELD
State KY
ZIP 42066
Phone 417 274-8328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Ambulance
Lab Director ALLEN JONES

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