18D2300145 CLIA NUMBER - KENTUCKYCARE 38

Laboratory Demographics

  • CLIA Code: 18D2300145
  • Facility Name: KENTUCKYCARE 38
  • Facility Address: 2200 WASHINGTON STREET
    PADUCAH, KY
    ZIP 42003
  • Facility Phone: 270 558-0450
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: MS. KRISTINE M. PRUITT
  • NPI Number: 1467555821
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2300145
LAB Type Federally Qualified Health Center
Facility Name KENTUCKYCARE 38
Street 2200 WASHINGTON STREET
City PADUCAH
State KY
ZIP 42003
Phone 270 558-0450
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2024
Certificate Expiration Date 3/4/2026
Facility Type Federally Qualified Health Center
Lab Director MS. KRISTINE M. PRUITT

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