18D2193778 CLIA NUMBER - CHANGES REHABILIATION LLC

Laboratory Demographics

  • CLIA Code: 18D2193778
  • Facility Name: CHANGES REHABILIATION LLC
  • Facility Address: 2000 HOLIDAY LANE
    FULTON, KY
    ZIP 42041
  • Facility Phone: (270) 297-4519
  • Facility Type: Other - RESIDENTIAL DRUG TX FAC
  • Facility Type: Waiver
  • Lab Director: ROBERT A. BAKER
  • NPI Number: 1891397485
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 18D2193778
LAB Type Other - RESIDENTIAL DRUG TX FAC
Facility Name CHANGES REHABILIATION LLC
Street 2000 HOLIDAY LANE
City FULTON
State KY
ZIP 42041
Phone 2702974519
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Other - RESIDENTIAL DRUG TX FAC
Lab Director ROBERT A. BAKER

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This page was last updated on: 5/18/2026