18D2291780 CLIA NUMBER - MOBILE CLINIC BY ONREQUEST LLC

Laboratory Demographics

  • CLIA Code: 18D2291780
  • Facility Name: MOBILE CLINIC BY ONREQUEST LLC
  • Facility Address: 10200 FOREST GREEN BLVD SUITE 112
    LOUISVILLE, KY
    ZIP 40223
  • Facility Phone: 502 901-2190
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: DR. ROBERT G. POPE
  • NPI Number: 1023187234
  • Taxonomy: 207QG0300X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2291780
LAB Type Mobile Laboratory
Facility Name MOBILE CLINIC BY ONREQUEST LLC
Street 10200 FOREST GREEN BLVD SUITE 112
City LOUISVILLE
State KY
ZIP 40223
Phone 502 901-2190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2023
Certificate Expiration Date 10/15/2025
Facility Type Mobile Laboratory
Lab Director DR. ROBERT G. POPE

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