18D2200620 CLIA NUMBER - UNITED SURGICAL ASSOCIATES DBA FAYETTE SURGICAL ASSOCIATES VASCULAR CENTER

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Laboratory Demographics

CLIA Number: 18D2200620

Facility Name: UNITED SURGICAL ASSOCIATES DBA FAYETTE SURGICAL ASSOCIATES VASCULAR CENTER

Facility Address:
2350 REGENCY RD SUITE A
LEXINGTON, KY
ZIP 40503
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Facility Phone Number: 859 278-4960

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508804717

Taxonomy: 2085R0001X - Radiology
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

CLIA Record

Field Name	Field Value
CLIA Number	18D2200620
LAB Type	Physician Office
Facility Name	UNITED SURGICAL ASSOCIATES DBA FAYETTE SURGICAL ASSOCIATES VASCULAR CENTER
Street	2350 REGENCY RD SUITE A
City	LEXINGTON
State	KY
ZIP	40503
Phone	859 278-4960
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024