18D2187630 CLIA NUMBER - PRACTICARE HOME CARE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 18D2187630
  • Facility Name: PRACTICARE HOME CARE SERVICES, LLC
  • Facility Address: 1667 RUSSELL LEE DR
    LOUISVILLE, KY
    ZIP 40211
  • Facility Phone: 502 939-6036
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MS. DEPHANY L. BIBB
  • NPI Number: 1265943716
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 18D2187630
LAB Type Practitioner Other
Facility Name PRACTICARE HOME CARE SERVICES, LLC
Street 1667 RUSSELL LEE DR
City LOUISVILLE
State KY
ZIP 40211
Phone 502 939-6036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Practitioner Other
Lab Director MS. DEPHANY L. BIBB

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