18D2298963 CLIA NUMBER - JACKSON COUNTY CLINIC

Laboratory Demographics

CLIA Number: 18D2298963

Facility Name: JACKSON COUNTY CLINIC

Facility Address:
200 W WATER ST
MC KEE, KY
ZIP 40447
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Facility Phone Number: 606 287-7711

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1275727380

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	18D2298963
LAB Type	Rural Health Clinic
Facility Name	JACKSON COUNTY CLINIC
Street	200 W WATER ST
City	MC KEE
State	KY
ZIP	40447
Phone	606 287-7711
CertificateType	4
CertificateEffectiveDate	2/12/2024
CertificateExpirationDate	2/11/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024