18D2089727 CLIA NUMBER - ST ELIZABETH PHYSICIANS GASTROENTEROLOGY

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Laboratory Demographics

CLIA Number: 18D2089727

Facility Name: ST ELIZABETH PHYSICIANS GASTROENTEROLOGY

Facility Address:
4900 HOUSTON RD 1D ENTRANCE 3RD FLOOR
FLORENCE, KY
ZIP 41042
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Facility Phone Number: 859 331-6466

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801869292

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D2089727
LAB Type	Physician Office
Facility Name	ST ELIZABETH PHYSICIANS GASTROENTEROLOGY
Street	4900 HOUSTON RD 1D ENTRANCE 3RD FLOOR
City	FLORENCE
State	KY
ZIP	41042
Phone	859 331-6466
CertificateType	4
CertificateEffectiveDate	1/7/2023
CertificateExpirationDate	1/6/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024