18D2177512 CLIA NUMBER - PURCHASE YOUTH VILLAGE

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CLIA Record

Field Name Field Value
CLIA Number 18D2177512
LAB Type Other - PRTF
Facility Name PURCHASE YOUTH VILLAGE
Street 473 OLD SYMSONIA RD
City BENTON
State KY
ZIP 42025
Phone 270 252-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Other - PRTF
Lab Director MS. CARISSA HATTON

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