18D2326085 CLIA NUMBER - ST ELIZABETH PHYSICIANS EDGEWOOD IM PEDS

Laboratory Demographics

  • CLIA Code: 18D2326085
  • Facility Name: ST ELIZABETH PHYSICIANS EDGEWOOD IM PEDS
  • Facility Address: 20 MEDICAL VILLAGE DRIVE, STE 308
    EDGEWOOD, KY
    ZIP 41017
  • Facility Phone: 859 578-5651
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MEREDITH A. LANDORF
  • NPI Number: 1093137812
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 18D2326085
LAB Type Physician Office
Facility Name ST ELIZABETH PHYSICIANS EDGEWOOD IM PEDS
Street 20 MEDICAL VILLAGE DRIVE, STE 308
City EDGEWOOD
State KY
ZIP 41017
Phone 859 578-5651
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Physician Office
Lab Director DR. MEREDITH A. LANDORF

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