18D2176720 CLIA NUMBER - MOUNTAIN COMPREHENSIVE CARE CENTER - CYNTHIANA HOME PLACE CLINIC

Laboratory Demographics

  • CLIA Code: 18D2176720
  • Facility Name: MOUNTAIN COMPREHENSIVE CARE CENTER - CYNTHIANA HOME PLACE CLINIC
  • Facility Address: 210 SOUTH WALNUT STREET
    CYNTHIANA, KY
    ZIP 41031
  • Facility Phone: 859 298-2011
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. KRISTIN FREEMAN
  • NPI Number: 1770121972
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2176720
LAB Type Federally Qualified Health Center
Facility Name MOUNTAIN COMPREHENSIVE CARE CENTER - CYNTHIANA HOME PLACE CLINIC
Street 210 SOUTH WALNUT STREET
City CYNTHIANA
State KY
ZIP 41031
Phone 859 298-2011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Federally Qualified Health Center
Lab Director DR. KRISTIN FREEMAN

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