18D2187378 CLIA NUMBER - DEACONESS HENDERSON PEDIATRIC ELM ST ERVIN

Laboratory Demographics

  • CLIA Code: 18D2187378
  • Facility Name: DEACONESS HENDERSON PEDIATRIC ELM ST ERVIN
  • Facility Address: 2018 NORTH ELM ST
    HENDERSON, KY
    ZIP 42420
  • Facility Phone: 270 827-3573
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ERIC ERVIN
  • NPI Number: 1487273397
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 18D2187378
LAB Type Physician Office
Facility Name DEACONESS HENDERSON PEDIATRIC ELM ST ERVIN
Street 2018 NORTH ELM ST
City HENDERSON
State KY
ZIP 42420
Phone 270 827-3573
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director DR. ERIC ERVIN

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