18D2066377 CLIA NUMBER - THACKER FAMILY MEDICAL LLC

Home > CLIA Lookup > 18D2066377

Laboratory Demographics

CLIA Number: 18D2066377

Facility Name: THACKER FAMILY MEDICAL LLC

Facility Address:
140 ADAMS LANE, SUITE 600-700
PIKEVILLE, KY
ZIP 41501
Get Directions

Facility Phone Number: 606 509-2000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134898364

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D2066377
LAB Type	Physician Office
Facility Name	THACKER FAMILY MEDICAL LLC
Street	140 ADAMS LANE, SUITE 600-700
City	PIKEVILLE
State	KY
ZIP	41501
Phone	606 509-2000
CertificateType	4
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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