18D2295428 CLIA NUMBER - JUNIPER HEALTH BREATHITT COUNTY ELEMENTARY SCHOOL

Laboratory Demographics

  • CLIA Code: 18D2295428
  • Facility Name: JUNIPER HEALTH BREATHITT COUNTY ELEMENTARY SCHOOL
  • Facility Address: 90 LBJ ROAD
    JACKSON, KY
    ZIP 41339
  • Facility Phone: 606 464-0151
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. DERRICK J. HAMILTON
  • NPI Number: 1528847670
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2295428
LAB Type Federally Qualified Health Center
Facility Name JUNIPER HEALTH BREATHITT COUNTY ELEMENTARY SCHOOL
Street 90 LBJ ROAD
City JACKSON
State KY
ZIP 41339
Phone 606 464-0151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Federally Qualified Health Center
Lab Director DR. DERRICK J. HAMILTON

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