18D2157313 CLIA NUMBER - KENTUCKY RIVER CLINICS

Laboratory Demographics

CLIA Number: 18D2157313

Facility Name: KENTUCKY RIVER CLINICS

Facility Address:
49 KY 15 NORTH
CAMPTON, KY
ZIP 41301
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Facility Phone Number: 606 666-6611

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780698563

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	18D2157313
LAB Type	Physician Office
Facility Name	KENTUCKY RIVER CLINICS
Street	49 KY 15 NORTH
City	CAMPTON
State	KY
ZIP	41301
Phone	606 666-6611
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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