18D2080563 CLIA NUMBER - AIR-EVAC LIFETEAM #120

Laboratory Demographics

  • CLIA Code: 18D2080563
  • Facility Name: AIR-EVAC LIFETEAM #120
  • Facility Address: 110 COUNTRY CLUB DRIVE
    MARION, KY
    ZIP 42064
  • Facility Phone: 270 704-9941
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MS. LEVA BLANDFORD
  • NPI Number: 1952715997
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 18D2080563
LAB Type Ambulance
Facility Name AIR-EVAC LIFETEAM #120
Street 110 COUNTRY CLUB DRIVE
City MARION
State KY
ZIP 42064
Phone 270 704-9941
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Ambulance
Lab Director MS. LEVA BLANDFORD

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This page was last updated on: 3/20/2025