18D2275602 CLIA NUMBER - EMERALD THERAPY CENTER, LLC - LIVINGWELL

Laboratory Demographics

  • CLIA Code: 18D2275602
  • Facility Name: EMERALD THERAPY CENTER, LLC - LIVINGWELL
  • Facility Address: 2327 NEW HOLT RD
    PADUCAH, KY
    ZIP 42001
  • Facility Phone: 270 534-5128
  • Facility Type: Other - BEHAVIORAL HEALTH SERVICE
  • Facility Type: Waiver
  • Lab Director: DR. SAMUEL KELLEY
  • NPI Number: 1023715281
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2275602
LAB Type Other - BEHAVIORAL HEALTH SERVICE
Facility Name EMERALD THERAPY CENTER, LLC - LIVINGWELL
Street 2327 NEW HOLT RD
City PADUCAH
State KY
ZIP 42001
Phone 270 534-5128
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other - BEHAVIORAL HEALTH SERVICE
Lab Director DR. SAMUEL KELLEY

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This page was last updated on: 3/20/2025