18D2089718 CLIA NUMBER - KUTTAWA CLINIC, PLLC

Laboratory Demographics

  • CLIA Code: 18D2089718
  • Facility Name: KUTTAWA CLINIC, PLLC
  • Facility Address: 91 CEDAR STREET
    KUTTAWA, KY
    ZIP 42055
  • Facility Phone: 270 388-7380
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DEBRA L. WILDER
  • NPI Number: 1184034951
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2089718
LAB Type Physician Office
Facility Name KUTTAWA CLINIC, PLLC
Street 91 CEDAR STREET
City KUTTAWA
State KY
ZIP 42055
Phone 270 388-7380
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Physician Office
Lab Director DEBRA L. WILDER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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