18D2144252 CLIA NUMBER - SOUTHERN KENTUCKY PRIMARY CARE, PSC

Laboratory Demographics

  • CLIA Code: 18D2144252
  • Facility Name: SOUTHERN KENTUCKY PRIMARY CARE, PSC
  • Facility Address: 101 W 2ND STREET
    RUSSELLVILLE, KY
    ZIP 42276
  • Facility Phone: 270 726-2602
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: GEETA S. CHAVDA
  • NPI Number: 1003327412
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2144252
LAB Type Rural Health Clinic
Facility Name SOUTHERN KENTUCKY PRIMARY CARE, PSC
Street 101 W 2ND STREET
City RUSSELLVILLE
State KY
ZIP 42276
Phone 270 726-2602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Rural Health Clinic
Lab Director GEETA S. CHAVDA

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