18D2073354 CLIA NUMBER - KENTUCKY CARE 44

Laboratory Demographics

  • CLIA Code: 18D2073354
  • Facility Name: KENTUCKY CARE 44
  • Facility Address: 3360 WAYNE SULLIVAN DRIVE
    PADUCAH, KY
    ZIP 42003
  • Facility Phone: 270 443-9474
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: MS. KRISTINE M. PRUITT
  • NPI Number: 1598186116
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2073354
LAB Type Federally Qualified Health Center
Facility Name KENTUCKY CARE 44
Street 3360 WAYNE SULLIVAN DRIVE
City PADUCAH
State KY
ZIP 42003
Phone 270 443-9474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Federally Qualified Health Center
Lab Director MS. KRISTINE M. PRUITT

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