18D2276627 CLIA NUMBER - ST ELIZABETH ADVANCED HEART FAILURE MANAGEMENT CENTER

Laboratory Demographics

  • CLIA Code: 18D2276627
  • Facility Name: ST ELIZABETH ADVANCED HEART FAILURE MANAGEMENT CENTER
  • Facility Address: 711 MEDICAL VILLAGE DR SUITE 310
    EDGEWOOD, KY
    ZIP 41017
  • Facility Phone: 859 301-0124
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. HAREE VONGOORU
  • NPI Number: 1548677636
  • Taxonomy: 213EP1101X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 18D2276627
LAB Type Physician Office
Facility Name ST ELIZABETH ADVANCED HEART FAILURE MANAGEMENT CENTER
Street 711 MEDICAL VILLAGE DR SUITE 310
City EDGEWOOD
State KY
ZIP 41017
Phone 859 301-0124
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Physician Office
Lab Director DR. HAREE VONGOORU

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