18D2104308 CLIA NUMBER - KENTUCKY PHARMACY 1 LLC DBA SHELBYVILLE PHARMACY

Laboratory Demographics

  • CLIA Code: 18D2104308
  • Facility Name: KENTUCKY PHARMACY 1 LLC DBA SHELBYVILLE PHARMACY
  • Facility Address: 182 FRANKFORT ROAD
    SHELBYVILLE, KY
    ZIP 40065
  • Facility Phone: 502 437-3008
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON UNDERWOOD
  • NPI Number: 1710043393
  • Taxonomy: 207W00000X - Ophthalmology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2104308
LAB Type Pharmacy
Facility Name KENTUCKY PHARMACY 1 LLC DBA SHELBYVILLE PHARMACY
Street 182 FRANKFORT ROAD
City SHELBYVILLE
State KY
ZIP 40065
Phone 502 437-3008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Pharmacy
Lab Director JASON UNDERWOOD

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: 6/4/2025