18D2052027 CLIA NUMBER - JESSAMINE COUNTY DETENTION CENTER

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Laboratory Demographics

CLIA Number: 18D2052027

Facility Name: JESSAMINE COUNTY DETENTION CENTER

Facility Address:
MEDICAL DEPT- SOUTHERN HEALTH PARTNERS, INC 229 EAST MAPLE STREET
NICHOLASVILLE, KY
ZIP 40356
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Facility Phone Number: 423 553-5635

Facility Type: Other - JAIL MEDICAL UNIT

Certificate Type: Waiver

NPI Number: 1215127303

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	18D2052027
LAB Type	Other - JAIL MEDICAL UNIT
Facility Name	JESSAMINE COUNTY DETENTION CENTER
Street	MEDICAL DEPT- SOUTHERN HEALTH PARTNERS, INC 229 EAST MAPLE STREET
City	NICHOLASVILLE
State	KY
ZIP	40356
Phone	423 553-5635
CertificateType	4
CertificateEffectiveDate	1/4/2023
CertificateExpirationDate	1/3/2025
FacilityType	Waiver

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