18D2295100 CLIA NUMBER - CHARLES C JOHNSON DO, PLLC

Laboratory Demographics

  • CLIA Code: 18D2295100
  • Facility Name: CHARLES C JOHNSON DO, PLLC
  • Facility Address: 3141 BEAUMONT CENTRE CIRCLE, SUITE 103
    LEXINGTON, KY
    ZIP 40513
  • Facility Phone: 859 523-0058
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHARLES C. JOHNSON
  • NPI Number: 1396428157
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2295100
LAB Type Physician Office
Facility Name CHARLES C JOHNSON DO, PLLC
Street 3141 BEAUMONT CENTRE CIRCLE, SUITE 103
City LEXINGTON
State KY
ZIP 40513
Phone 859 523-0058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Physician Office
Lab Director DR. CHARLES C. JOHNSON

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