18D2305149 CLIA NUMBER - MOUNTAIN COMPREHENSIVE CARE CENTER, INC - HOMEPLACE CLINIC

Laboratory Demographics

  • CLIA Code: 18D2305149
  • Facility Name: MOUNTAIN COMPREHENSIVE CARE CENTER, INC - HOMEPLACE CLINIC
  • Facility Address: 456 SOUTH LAKE DRIVE
    PRESTONSBURG, KY
    ZIP 41653
  • Facility Phone: 606 886-8572
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. KRISTIN FREEMAN
  • NPI Number: 1699456129
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2305149
LAB Type Federally Qualified Health Center
Facility Name MOUNTAIN COMPREHENSIVE CARE CENTER, INC - HOMEPLACE CLINIC
Street 456 SOUTH LAKE DRIVE
City PRESTONSBURG
State KY
ZIP 41653
Phone 606 886-8572
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Federally Qualified Health Center
Lab Director DR. KRISTIN FREEMAN

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