18D2259081 CLIA NUMBER - OHIO COUNTY HEALTHCARE BEHAVIORAL HEALTH

Laboratory Demographics

CLIA Number: 18D2259081

Facility Name: OHIO COUNTY HEALTHCARE BEHAVIORAL HEALTH

Facility Address:
1621 N MAIN STREET
BEAVER DAM, KY
ZIP 42320
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Facility Phone Number: 270 274-9222

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1740953603

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D2259081
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	OHIO COUNTY HEALTHCARE BEHAVIORAL HEALTH
Street	1621 N MAIN STREET
City	BEAVER DAM
State	KY
ZIP	42320
Phone	270 274-9222
CertificateType	4
CertificateEffectiveDate	5/2/2022
CertificateExpirationDate	5/1/2024
FacilityType	Waiver

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