18D2284600 CLIA NUMBER - ADVANCED CLINICAL CONSULTANTS, PLLC

Laboratory Demographics

  • CLIA Code: 18D2284600
  • Facility Name: ADVANCED CLINICAL CONSULTANTS, PLLC
  • Facility Address: 24 OLD SOUTHFORK ROAD
    KINGS MOUNTAIN, KY
    ZIP 40442
  • Facility Phone: (606) 448-0693
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MR. GLEN WARE
  • NPI Number: 1609570563
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 18D2284600
LAB Type Mobile Laboratory
Facility Name ADVANCED CLINICAL CONSULTANTS, PLLC
Street 24 OLD SOUTHFORK ROAD
City KINGS MOUNTAIN
State KY
ZIP 40442
Phone 6064480693
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Mobile Laboratory
Lab Director MR. GLEN WARE

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This page was last updated on: 6/29/2026