18D2122409 CLIA NUMBER - PIONEER HEALTH GROUP LLC

Laboratory Demographics

CLIA Number: 18D2122409

Facility Name: PIONEER HEALTH GROUP LLC

Facility Address:
107 E MADISON ST
LOUISA, KY
ZIP 41230
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Facility Phone Number: 606 638-0938

Facility Type: Independent

Certificate Type: Certificate of Compliance

NPI Number: 1023691599

Taxonomy: 207QA0401X - Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.

CLIA Record

Field Name	Field Value
CLIA Number	18D2122409
LAB Type	Independent
Facility Name	PIONEER HEALTH GROUP LLC
Street	107 E MADISON ST
City	LOUISA
State	KY
ZIP	41230
Phone	606 638-0938
CertificateType	2
CertificateEffectiveDate	4/4/2023
CertificateExpirationDate	4/3/2025
FacilityType	Compliance

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