18D2156385 CLIA NUMBER - LAKESIDE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 18D2156385
  • Facility Name: LAKESIDE PRIMARY CARE
  • Facility Address: 6470 S HWY 27
    SOMERSET, KY
    ZIP 42501
  • Facility Phone: 606 310-2640
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. DENNIS ULRICH
  • NPI Number: 1043790983
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2156385
LAB Type Rural Health Clinic
Facility Name LAKESIDE PRIMARY CARE
Street 6470 S HWY 27
City SOMERSET
State KY
ZIP 42501
Phone 606 310-2640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Rural Health Clinic
Lab Director DR. DENNIS ULRICH

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