18D2283564 CLIA NUMBER - BLUEGRASS DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 18D2283564
  • Facility Name: BLUEGRASS DIRECT PRIMARY CARE
  • Facility Address: 227 EAST MAIN ST
    GEORGETOWN, KY
    ZIP 40324
  • Facility Phone: 859 710-6300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. COLTON T. JAYNE
  • NPI Number: 1700582327
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2283564
LAB Type Physician Office
Facility Name BLUEGRASS DIRECT PRIMARY CARE
Street 227 EAST MAIN ST
City GEORGETOWN
State KY
ZIP 40324
Phone 859 710-6300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Physician Office
Lab Director DR. COLTON T. JAYNE

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