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General NPI Number Information
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NPI Number | 1881697464
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Entity Type | Organization
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Legal Business Name | CLINICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 2935 BRECKENRIDGE LN STE 101
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City | LOUISVILLE
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State | KY
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Zip | 40220-1408
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Country | US
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Telephone | 502-897-9594
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Fax | 502-896-1808
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Provider Business Mailing Address
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Address Line | PO BOX 538359
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City | ATLANTA
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State | GA
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Zip | 30353-8359
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Country | US
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Telephone | 502-897-9594
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Fax | 502-896-1808
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Authorized Official
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Title or Position | DIRECTOR FINANCE BILLING
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Name | DIANNE S ROWAN
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Credential |
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Telephone | 502-897-9594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 200291
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 200291
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License Number State | KY
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