18D2062879 CLIA NUMBER - DEACONESS CLINIC PED ELM ST

Laboratory Demographics

  • CLIA Code: 18D2062879
  • Facility Name: DEACONESS CLINIC PED ELM ST
  • Facility Address: 2018 N ELM STREET
    HENDERSON, KY
    ZIP 42420
  • Facility Phone: 270 827-7512
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ERIC ERVIN
  • NPI Number: 1124522750
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2062879
LAB Type Physician Office
Facility Name DEACONESS CLINIC PED ELM ST
Street 2018 N ELM STREET
City HENDERSON
State KY
ZIP 42420
Phone 270 827-7512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director DR. ERIC ERVIN

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