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Contact Information

ARCHER CLINIC LABORATORY
400 UNIVERSITY DR
SUITE 105
PRESTONSBURG, KY41653-1080
 Phone: 606-886-6302
 Fax: 606-886-0597
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for ARCHER CLINIC LABORATORY

NPI Number 1295736841
LBN Legal business name ARCHER CLINIC LABORATORY
Authorized official NOEL GILLIAM - (LABORATORY MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/04/2005
Last updated 12/31/2007 - About 18 years ago
Identifiers
KY License # 200111
KY Medicaid 37901055
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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