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18D2168558 CLIA NUMBER - BLUEGRASS INTERNAL MEDICINE WAIVED

Laboratory Demographics

CLIA Number: 18D2168558

Facility Name: BLUEGRASS INTERNAL MEDICINE WAIVED

Facility Address:
3346 PROFESSIONAL PARK DR
OWENSBORO, KY
ZIP 42303
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Facility Phone Number: 270 685-1066

Facility Type: Independent

Certificate Type: Waiver
NPI Number: 1619973682

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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 270 685-1066
CertificateType 4
CertificateEffectiveDate 7/2/2023
CertificateExpirationDate 7/1/2025
FacilityType Waiver

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