18D2135045 CLIA NUMBER - ELKHORN DERMATOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 18D2135045
  • Facility Name: ELKHORN DERMATOLOGY, PLLC
  • Facility Address: 304 BOSTON SQUARE
    GEORGETOWN, KY
    ZIP 40324
  • Facility Phone: 502 316-9425
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHASE L. WILSON
  • NPI Number: 1841722980
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 18D2135045
LAB Type Physician Office
Facility Name ELKHORN DERMATOLOGY, PLLC
Street 304 BOSTON SQUARE
City GEORGETOWN
State KY
ZIP 40324
Phone 502 316-9425
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2023
Certificate Expiration Date 11/9/2025
Facility Type Physician Office
Lab Director DR. CHASE L. WILSON

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