18D2225529 CLIA NUMBER - MCH PRIMARY CARE ELKTON

Laboratory Demographics

  • CLIA Code: 18D2225529
  • Facility Name: MCH PRIMARY CARE ELKTON
  • Facility Address: 118 SOUTH MAIN ST
    ELKTON, KY
    ZIP 42220
  • Facility Phone: 270 265-5023
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KELLY S. TATE
  • NPI Number: 1427720994
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2225529
LAB Type Physician Office
Facility Name MCH PRIMARY CARE ELKTON
Street 118 SOUTH MAIN ST
City ELKTON
State KY
ZIP 42220
Phone 270 265-5023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Physician Office
Lab Director DR. KELLY S. TATE

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