18D2294407 CLIA NUMBER - TRACY'S RESIDENTIAL REENTRY CENTER, INC

Laboratory Demographics

  • CLIA Code: 18D2294407
  • Facility Name: TRACY'S RESIDENTIAL REENTRY CENTER, INC
  • Facility Address: 1365 DAVENPORT DR
    LEXINGTON, KY
    ZIP 40504
  • Facility Phone: 859 309-2240
  • Facility Type: Other - RESIDENTIAL AODE REHAB
  • Facility Type: Waiver
  • Lab Director: MS. CHIQUITA SHIELDS
  • NPI Number: 1932823929
  • Taxonomy: 101YP2500X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 18D2294407
LAB Type Other - RESIDENTIAL AODE REHAB
Facility Name TRACY'S RESIDENTIAL REENTRY CENTER, INC
Street 1365 DAVENPORT DR
City LEXINGTON
State KY
ZIP 40504
Phone 859 309-2240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Other - RESIDENTIAL AODE REHAB
Lab Director MS. CHIQUITA SHIELDS

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