18D2168359 CLIA NUMBER - COUNTY LINE PRIMARY CARE LLC DBA JACKSON MEDICAL CLINIC FAMILY HEALTH

Laboratory Demographics

  • CLIA Code: 18D2168359
  • Facility Name: COUNTY LINE PRIMARY CARE LLC DBA JACKSON MEDICAL CLINIC FAMILY HEALTH
  • Facility Address: 1550 HWY 15 S SUITE 240
    JACKSON, KY
    ZIP 41339
  • Facility Phone: 606 824-5037
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MS. JESSICA A. NEACE
  • NPI Number: 1609378132
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2168359
LAB Type Rural Health Clinic
Facility Name COUNTY LINE PRIMARY CARE LLC DBA JACKSON MEDICAL CLINIC FAMILY HEALTH
Street 1550 HWY 15 S SUITE 240
City JACKSON
State KY
ZIP 41339
Phone 606 824-5037
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Rural Health Clinic
Lab Director MS. JESSICA A. NEACE

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