18D2247447 CLIA NUMBER - AZALEA HEALTH & SKIN TREATMENT CENTER

Laboratory Demographics

CLIA Number: 18D2247447

Facility Name: AZALEA HEALTH & SKIN TREATMENT CENTER

Facility Address:
1000 ASHLAND DR 303
ASHLAND, KY
ZIP 41101
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Facility Phone Number: 606 467-2360

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407514532

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	18D2247447
LAB Type	Physician Office
Facility Name	AZALEA HEALTH & SKIN TREATMENT CENTER
Street	1000 ASHLAND DR 303
City	ASHLAND
State	KY
ZIP	41101
Phone	606 467-2360
CertificateType	4
CertificateEffectiveDate	1/6/2024
CertificateExpirationDate	1/5/2026
FacilityType	Waiver

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