18D2107585 CLIA NUMBER - KIOSK MEDICINE KENTUCKY LLC

Laboratory Demographics

CLIA Number: 18D2107585

Facility Name: KIOSK MEDICINE KENTUCKY LLC

Facility Address:
300 BRIGHTON PARK BLVD
FRANKFORT, KY
ZIP 40601
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Facility Phone Number: 502 848-5904

Facility Type: Other - WALK IN HEALTH CARE

Certificate Type: Waiver

NPI Number: 1104290782

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	18D2107585
LAB Type	Other - WALK IN HEALTH CARE
Facility Name	KIOSK MEDICINE KENTUCKY LLC
Street	300 BRIGHTON PARK BLVD
City	FRANKFORT
State	KY
ZIP	40601
Phone	502 848-5904
CertificateType	4
CertificateEffectiveDate	1/19/2024
CertificateExpirationDate	1/18/2026
FacilityType	Waiver

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