18D2119759 CLIA NUMBER - GEORGETOWN MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 18D2119759
  • Facility Name: GEORGETOWN MEDICAL, LLC
  • Facility Address: 105 EASTSIDE DRIVE
    GEORGETOWN, KY
    ZIP 40324
  • Facility Phone: (502) 868-0664
  • Facility Type: Other - ALCOHOL AND DRUG TREATMEN
  • Facility Type: Waiver
  • Lab Director: DR. LORI N. LEGRAND
  • NPI Number: 1063824381
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2119759
LAB Type Other - ALCOHOL AND DRUG TREATMEN
Facility Name GEORGETOWN MEDICAL, LLC
Street 105 EASTSIDE DRIVE
City GEORGETOWN
State KY
ZIP 40324
Phone 5028680664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Other - ALCOHOL AND DRUG TREATMEN
Lab Director DR. LORI N. LEGRAND

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This page was last updated on: 5/18/2026