18D2063200 CLIA NUMBER - FLAGET PRIMARY CARE ASSOCIATES - WILLISBURG RHC

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Laboratory Demographics

CLIA Number: 18D2063200

Facility Name: FLAGET PRIMARY CARE ASSOCIATES - WILLISBURG RHC

Facility Address:
2387 MAIN ST
WILLISBURG, KY
ZIP 40078
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Facility Phone Number: 859 375-3023

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1316553167

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D2063200
LAB Type	Rural Health Clinic
Facility Name	FLAGET PRIMARY CARE ASSOCIATES - WILLISBURG RHC
Street	2387 MAIN ST
City	WILLISBURG
State	KY
ZIP	40078
Phone	859 375-3023
CertificateType	4
CertificateEffectiveDate	1/22/2024
CertificateExpirationDate	1/21/2026
FacilityType	Waiver

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