18D2241715 CLIA NUMBER - PREMISE HEALTH OF KENTUCKY MEDICAL, PSC DBA PREMISE HEALTH WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 18D2241715
  • Facility Name: PREMISE HEALTH OF KENTUCKY MEDICAL, PSC DBA PREMISE HEALTH WELLNESS CENTER
  • Facility Address: 10000 BROWNSBORO RD SUITE 7
    LOUISVILLE, KY
    ZIP 40201
  • Facility Phone: 502 272-0330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JENNIFER CRAIG
  • NPI Number: 1275203028
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2241715
LAB Type Physician Office
Facility Name PREMISE HEALTH OF KENTUCKY MEDICAL, PSC DBA PREMISE HEALTH WELLNESS CENTER
Street 10000 BROWNSBORO RD SUITE 7
City LOUISVILLE
State KY
ZIP 40201
Phone 502 272-0330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DR. JENNIFER CRAIG

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This page was last updated on: 6/4/2025