18D2270238 CLIA NUMBER - PATRIOT ONE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 18D2270238
  • Facility Name: PATRIOT ONE PRIMARY CARE
  • Facility Address: 989 GOVERNORS LN STE 220
    LEXINGTON, KY
    ZIP 40513
  • Facility Phone: 859 447-8014
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. ELIZABETH K. MENTZER
  • NPI Number: 1699410548
  • Taxonomy: 363AM0700X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 18D2270238
LAB Type Physician Office
Facility Name PATRIOT ONE PRIMARY CARE
Street 989 GOVERNORS LN STE 220
City LEXINGTON
State KY
ZIP 40513
Phone 859 447-8014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2024
Certificate Expiration Date 10/11/2026
Facility Type Physician Office
Lab Director MS. ELIZABETH K. MENTZER

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