18D2300714 CLIA NUMBER - KENTUCKY PHOENIX PROJECT LLC

Laboratory Demographics

  • CLIA Code: 18D2300714
  • Facility Name: KENTUCKY PHOENIX PROJECT LLC
  • Facility Address: 5230 KY RT 321 SUITE 6
    PRESTONSBURG, KY
    ZIP 41653
  • Facility Phone: 606 459-5001
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: MR. CASEY COLLIER
  • NPI Number: 1639956527
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2300714
LAB Type Ancillary Testing Site in Health Care Center
Facility Name KENTUCKY PHOENIX PROJECT LLC
Street 5230 KY RT 321 SUITE 6
City PRESTONSBURG
State KY
ZIP 41653
Phone 606 459-5001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director MR. CASEY COLLIER

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