18D2175042 CLIA NUMBER - DMMD CONCIERGE, LLC

Laboratory Demographics

  • CLIA Code: 18D2175042
  • Facility Name: DMMD CONCIERGE, LLC
  • Facility Address: 947 EASTERN PARKWAY
    LOUISVILLE, KY
    ZIP 40217
  • Facility Phone: 502 361-8801
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DOUG E. MATTINGLY
  • NPI Number: 1114562014
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2175042
LAB Type Physician Office
Facility Name DMMD CONCIERGE, LLC
Street 947 EASTERN PARKWAY
City LOUISVILLE
State KY
ZIP 40217
Phone 502 361-8801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Physician Office
Lab Director DR. DOUG E. MATTINGLY

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