18D2266646 CLIA NUMBER - WELGEN ONE OF KENTUCKY, LLC

Laboratory Demographics

CLIA Number: 18D2266646

Facility Name: WELGEN ONE OF KENTUCKY, LLC

Facility Address:
629 S FOURTH STREET, SUITE 301
LOUISVILLE, KY
ZIP 40202
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Facility Phone Number: 833 935-4361

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023746732

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	18D2266646
LAB Type	Physician Office
Facility Name	WELGEN ONE OF KENTUCKY, LLC
Street	629 S FOURTH STREET, SUITE 301
City	LOUISVILLE
State	KY
ZIP	40202
Phone	833 935-4361
CertificateType	4
CertificateEffectiveDate	8/15/2022
CertificateExpirationDate	8/14/2024
FacilityType	Waiver

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