18D2247850 CLIA NUMBER - SHANNON P JOHNSON DMD

Laboratory Demographics

  • CLIA Code: 18D2247850
  • Facility Name: SHANNON P JOHNSON DMD
  • Facility Address: 9510 ORMSBY STATION RD SUITE 203
    LOUISVILLE, KY
    ZIP 40223
  • Facility Phone: 502 805-0500
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. SHANNON P. JOHNSON
  • NPI Number: 1316579279
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2247850
LAB Type Practitioner Other
Facility Name SHANNON P JOHNSON DMD
Street 9510 ORMSBY STATION RD SUITE 203
City LOUISVILLE
State KY
ZIP 40223
Phone 502 805-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2024
Certificate Expiration Date 1/9/2026
Facility Type Practitioner Other
Lab Director DR. SHANNON P. JOHNSON

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