18D2279012 CLIA NUMBER - MOUNTAIN FAMILY PRACTICE CLINIC OF MANCHESTER

Laboratory Demographics

  • CLIA Code: 18D2279012
  • Facility Name: MOUNTAIN FAMILY PRACTICE CLINIC OF MANCHESTER
  • Facility Address: 108 MANCHESTER SHOPPING CENTER
    MANCHESTER, KY
    ZIP 40962
  • Facility Phone: 606 658-6333
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. JOEL STEPHENSON
  • NPI Number: 1922275395
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 18D2279012
LAB Type Physician Office
Facility Name MOUNTAIN FAMILY PRACTICE CLINIC OF MANCHESTER
Street 108 MANCHESTER SHOPPING CENTER
City MANCHESTER
State KY
ZIP 40962
Phone 606 658-6333
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 3/19/2024
Certificate Expiration Date 3/18/2026
Facility Type Physician Office
Lab Director DR. JOEL STEPHENSON

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