Organization
PHYSICIANS CLINICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL KELLY (OFFICE MANAGER)
(270) 688-1225
Entity
Organization
Contact information
Practice address
815 E PARRISH AVE, OWENSBORO, KY 42303-3222
(270) 688-1200
(270) 688-1204
Mailing address
815 E PARRISH AVE, OWENSBORO, KY 42303-3222
(270) 688-1200
(270) 688-1204
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
200254
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000229569
BCBS PROVIDER ID
KY
Enumeration date
06/13/2005
Last updated
08/22/2020
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