18D2080497 CLIA NUMBER - ADVANCED INTERNAL MEDICINE, PLLC

Laboratory Demographics

  • CLIA Code: 18D2080497
  • Facility Name: ADVANCED INTERNAL MEDICINE, PLLC
  • Facility Address: 2005 BROADWAY STREET
    PADUCAH, KY
    ZIP 42001
  • Facility Phone: (270) 366-7650
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RYAN C. FRAZINE
  • NPI Number: 1336563543
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2080497
LAB Type Physician Office
Facility Name ADVANCED INTERNAL MEDICINE, PLLC
Street 2005 BROADWAY STREET
City PADUCAH
State KY
ZIP 42001
Phone 2703667650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Physician Office
Lab Director DR. RYAN C. FRAZINE

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This page was last updated on: 5/18/2026