18D2240227 CLIA NUMBER - AIR EVAC LIFETEAM AEL 173

Laboratory Demographics

  • CLIA Code: 18D2240227
  • Facility Name: AIR EVAC LIFETEAM AEL 173
  • Facility Address: 425 WEST WALNUT STREET
    LEBANON, KY
    ZIP 40033
  • Facility Phone: 270 940-3347
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MS. DEVONA WRIGHT
  • NPI Number: 1417628595
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 18D2240227
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM AEL 173
Street 425 WEST WALNUT STREET
City LEBANON
State KY
ZIP 40033
Phone 270 940-3347
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Mobile Laboratory
Lab Director MS. DEVONA WRIGHT

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