18D2112596 CLIA NUMBER - GRATEFUL DOC, LLC

Laboratory Demographics

  • CLIA Code: 18D2112596
  • Facility Name: GRATEFUL DOC, LLC
  • Facility Address: 2101 NICHOLASVILLE ROAD, SUITE 400
    LEXINGTON, KY
    ZIP 40503
  • Facility Phone: 859 373-0643
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DEBBIE FIBEL
  • NPI Number: 1578924197
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2112596
LAB Type Physician Office
Facility Name GRATEFUL DOC, LLC
Street 2101 NICHOLASVILLE ROAD, SUITE 400
City LEXINGTON
State KY
ZIP 40503
Phone 859 373-0643
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 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director DEBBIE FIBEL

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