18D2136780 CLIA NUMBER - EVERSIDE HEALTH, LLC - LOCAL 392 CLINIC

Laboratory Demographics

  • CLIA Code: 18D2136780
  • Facility Name: EVERSIDE HEALTH, LLC - LOCAL 392 CLINIC
  • Facility Address: 600 RODEO DRIVE, STE 300
    ERLANGER, KY
    ZIP 41018
  • Facility Phone: (773) 697-3144
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. TRACY MAHANEY
  • NPI Number: 1093360059
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2136780
LAB Type Physician Office
Facility Name EVERSIDE HEALTH, LLC - LOCAL 392 CLINIC
Street 600 RODEO DRIVE, STE 300
City ERLANGER
State KY
ZIP 41018
Phone 7736973144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Physician Office
Lab Director MS. TRACY MAHANEY

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