CLIA lab
CLIA 18D2290893: Kentuckycare 58
Fulton, KY. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 18D2290893 belongs to Kentuckycare 58 in Fulton, KY.
Certificate of Waiver, effective October 3, 2025, expires October 2, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 3, 2025
- Certificate expiration
- October 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 3, 2023
- Facility type
- Federally qualified health center
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 18D2290893
- Lab name
- Kentuckycare 58
- Address
- 2006 Holiday Lane, Fulton, KY 42041
- Phone
- (270) 413-1001
- Fax
- (270) 413-1003
Annual test volume the lab reported
- Waived tests
- 780
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Fulton, KY
- Evans Drug Company LLCCertificate of Waiver, Pharmacy18D2194160
- Fulton Nursing and Rehabilitation, LLCCertificate of Waiver, Skilled nursing or nursing facility18D0673545
- Jackson Purchase Primary Care Fulton ClinicCertificate of Waiver, Rural health clinic18D2126241
- Laven Care LLCCertificate of Waiver, Mobile lab18D2284383
- Lifeline Home Health Care of Fulton,llc DBACertificate of Waiver, Home health agency18D1070308
- Southern Vascular & Pain Surgery Center LLCCertificate of Waiver, Ambulatory surgery center18D2296766
- Twin City Ambulance ServiceCertificate of Waiver, Ambulance18D2149020
- Wal-Mart Stores East, LP DBA Wal-Mart Pharmacy #10Certificate of Waiver, Pharmacy18D2142931
Related
Questions
What is the CLIA number for Kentuckycare 58 in Fulton?
18D2290893, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kentuckycare 58 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 18D2290893 expire?
The CMS file lists October 2, 2027 as the certificate expiration date; the certificate took effect October 3, 2025.