18D2287397 CLIA NUMBER - SPARC RECOVERY

Laboratory Demographics

  • CLIA Code: 18D2287397
  • Facility Name: SPARC RECOVERY
  • Facility Address: 50 LUDA STREET
    RUSSELL SPRINGS, KY
    ZIP 42642
  • Facility Phone: 270 866-4174
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. CORY RYAN
  • NPI Number: 1790447274
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 18D2287397
LAB Type Physician Office
Facility Name SPARC RECOVERY
Street 50 LUDA STREET
City RUSSELL SPRINGS
State KY
ZIP 42642
Phone 270 866-4174
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 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Physician Office
Lab Director DR. CORY RYAN

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