18D2081282 CLIA NUMBER - GRAVES GILBERT CLINIC - GRANESE PATHOLOGY LAB

Laboratory Demographics

  • CLIA Code: 18D2081282
  • Facility Name: GRAVES GILBERT CLINIC - GRANESE PATHOLOGY LAB
  • Facility Address: 1065 ASHLEY STREET, STE 200
    BOWLING GREEN, KY
    ZIP 42103
  • Facility Phone: 270 393-2795
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JACQUELINE GRANESE
  • NPI Number: 1063864056
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 18D2081282
LAB Type Independent
Facility Name GRAVES GILBERT CLINIC - GRANESE PATHOLOGY LAB
Street 1065 ASHLEY STREET, STE 200
City BOWLING GREEN
State KY
ZIP 42103
Phone 270 393-2795
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/16/2025
Certificate Expiration Date 1/15/2027
Facility Type Independent
Lab Director DR. JACQUELINE GRANESE

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