18D2041339 CLIA NUMBER - KIOSK MEDICINE OF KENTUCKY, LLC

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Laboratory Demographics

CLIA Number: 18D2041339

Facility Name: KIOSK MEDICINE OF KENTUCKY, LLC

Facility Address:
2150 DIXIE HIGHWAY
FORT MITCHELL, KY
ZIP 41017
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Facility Phone Number: 859 292-1784

Facility Type: Other - WALK-IN HEALTHCARE CLINIC

Certificate Type: Waiver

NPI Number: 1376966358

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	18D2041339
LAB Type	Other - WALK-IN HEALTHCARE CLINIC
Facility Name	KIOSK MEDICINE OF KENTUCKY, LLC
Street	2150 DIXIE HIGHWAY
City	FORT MITCHELL
State	KY
ZIP	41017
Phone	859 292-1784
CertificateType	4
CertificateEffectiveDate	5/21/2022
CertificateExpirationDate	5/20/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024