18D2308485 CLIA NUMBER - PHOENIX PLACE

Laboratory Demographics

  • CLIA Code: 18D2308485
  • Facility Name: PHOENIX PLACE
  • Facility Address: 2012 W CHESTNUT STREET
    LOUISVILLE, KY
    ZIP 40203
  • Facility Phone: 502 656-9261
  • Facility Type: Other - BEHAVIORAL HEALTH ORGANIZ
  • Facility Type: Waiver
  • Lab Director: MS. DIAMOND CALLOWAY
  • NPI Number: 1740065713
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 18D2308485
LAB Type Other - BEHAVIORAL HEALTH ORGANIZ
Facility Name PHOENIX PLACE
Street 2012 W CHESTNUT STREET
City LOUISVILLE
State KY
ZIP 40203
Phone 502 656-9261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Other - BEHAVIORAL HEALTH ORGANIZ
Lab Director MS. DIAMOND CALLOWAY

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