18D2052146 CLIA NUMBER - CENTRAL KENTUCKY EAR, NOSE & THROAT RICHMOND

Laboratory Demographics

  • CLIA Code: 18D2052146
  • Facility Name: CENTRAL KENTUCKY EAR, NOSE & THROAT RICHMOND
  • Facility Address: 1012 IVAL JAMES BLVD, SUITE B
    RICHMOND, KY
    ZIP 40475
  • Facility Phone: 859 624-3615
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAY VAN METRE
  • NPI Number: 1508940099
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 18D2052146
LAB Type Physician Office
Facility Name CENTRAL KENTUCKY EAR, NOSE & THROAT RICHMOND
Street 1012 IVAL JAMES BLVD, SUITE B
City RICHMOND
State KY
ZIP 40475
Phone 859 624-3615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Physician Office
Lab Director DR. RAY VAN METRE

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