18D2302455 CLIA NUMBER - CENTRAL KENTUCKY PAIN AND SPINE, A DEPARTMENT OF GEORGETOWN COMMUNITY HOSPITAL

Laboratory Demographics

  • CLIA Code: 18D2302455
  • Facility Name: CENTRAL KENTUCKY PAIN AND SPINE, A DEPARTMENT OF GEORGETOWN COMMUNITY HOSPITAL
  • Facility Address: 105 PRATHER PATH, SUITE 2400
    GEORGETOWN, KY
    ZIP 40324
  • Facility Phone: 502 570-3767
  • Facility Type: Other - PROVIDER BASED DEPT, HOSP
  • Facility Type: Waiver
  • Lab Director: DR. VINOD MUNISWAMY
  • NPI Number: 1912148875
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 18D2302455
LAB Type Other - PROVIDER BASED DEPT, HOSP
Facility Name CENTRAL KENTUCKY PAIN AND SPINE, A DEPARTMENT OF GEORGETOWN COMMUNITY HOSPITAL
Street 105 PRATHER PATH, SUITE 2400
City GEORGETOWN
State KY
ZIP 40324
Phone 502 570-3767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Other - PROVIDER BASED DEPT, HOSP
Lab Director DR. VINOD MUNISWAMY

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