18D2162097 CLIA NUMBER - DEACONESS CLINIC KLUTEY PARK

Laboratory Demographics

  • CLIA Code: 18D2162097
  • Facility Name: DEACONESS CLINIC KLUTEY PARK
  • Facility Address: 471 KLUTEY PARK DRIVE
    HENDERSON, KY
    ZIP 42420
  • Facility Phone: 270 830-6100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. CHARLES H. FUTRELL
  • NPI Number: 1104445014
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2162097
LAB Type Physician Office
Facility Name DEACONESS CLINIC KLUTEY PARK
Street 471 KLUTEY PARK DRIVE
City HENDERSON
State KY
ZIP 42420
Phone 270 830-6100
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Physician Office
Lab Director DR. CHARLES H. FUTRELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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