18D2168558 CLIA NUMBER - BLUEGRASS INTERNAL MEDICINE WAIVED

Laboratory Demographics

  • CLIA Code: 18D2168558
  • Facility Name: BLUEGRASS INTERNAL MEDICINE WAIVED
  • Facility Address: 3346 PROFESSIONAL PARK DR
    OWENSBORO, KY
    ZIP 42303
  • Facility Phone: (270) 685-1066
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DR. ANGELA JARVIS
  • NPI Number: 1619973682
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2168558
LAB Type Independent
Facility Name BLUEGRASS INTERNAL MEDICINE WAIVED
Street 3346 PROFESSIONAL PARK DR
City OWENSBORO
State KY
ZIP 42303
Phone 2706851066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Independent
Lab Director DR. ANGELA JARVIS

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This page was last updated on: 5/18/2026