18D2230411 CLIA NUMBER - NEPHROLOGY CLINIC

Laboratory Demographics

CLIA Number: 18D2230411

Facility Name: NEPHROLOGY CLINIC

Facility Address:
135 EAST MAXWELL STREET, SUITE 401
LEXINGTON, KY
ZIP 40508
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Facility Phone Number: 859 323-2891

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1386057990

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	18D2230411
LAB Type	Physician Office
Facility Name	NEPHROLOGY CLINIC
Street	135 EAST MAXWELL STREET, SUITE 401
City	LEXINGTON
State	KY
ZIP	40508
Phone	859 323-2891
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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