Supporters of legal access to abortion, as well as anti-abortion activists, rally outside the Supreme Court in Washington, DC, March 2, 2016, (Credit: SAUL LOEB/AFP/Getty Images)

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The only abortion provider in Kentucky could be required to close its doors Monday.

EMW Women’s Surgical Center, based in Louisville, received a letter “out of the blue” on March 13 from the state’s Cabinet for Health and Family Services that said the center would lose its license in 10 days, according to court records. The Cabinet granted an extension until April 3.

EMW, later joined by the ACLU, filed a lawsuit in Western District of Kentucky to stop the closure. The Kentucky Cabinet for Health and Family Services has not responded to a request for comment.

The letter from the state, which was included in the lawsuit, said the surgical center’s agreements with a local hospital and ambulance are “deficient.” The agreements are required in case of an emergency.

The cabinet’s letter of notice says that the chair of the department of obstetrics, gynecology and women’s health is “not authorized” to sign the hospital agreement and that the agreement with the ambulance company does not offer “certainty” that a patient would receive a medically appropriate transfer in case of an emergency.

“Failure to cure these deficiencies will result in an immediate revocation of the Abortion Facility license,” the letter said.

In its complaint, EMW said there were no previous issues with its hospital agreement, which has been unchanged since 2014, and its emergency services agreement, which has been virtually unchanged since 2009. EMW’s license was renewed last year and was valid until May 2017, according to the center’s attorney, Don Cox.

“What is so disturbing is the basis for rejection of our rights to continue to be licensed are the very issues that were resolved in our favor a year ago” during the licensing process, Cox told CNN.

“The state’s bureaucratic sleight of hand is fooling no one. This is an attempt to ban abortion in Kentucky, plain and simple. We are fighting to keep this from happening,” Brigitte Amiri, a senior staff attorney with the ACLU’s Reproductive Freedom Project, said in a statement. The ACLU is also a plaintiff in the case.

Laws signed by Republican Gov. Matt Bevin this year put tighter restrictions on abortions in the state. The state now requires that the physician or technician conducting the abortion perform an ultrasound, describe and display the ultrasound images to the mother, and provide audio of the fetal heartbeat to the mother before she may have an abortion. The ACLU and EMW filed a separate lawsuit this year against the provisions. The case is ongoing.

EMW filed a request for a temporary restraining order on Thursday to stop the closure until further hearings can be held about the case. No hearing has been scheduled for a judge to approve or deny the temporary restraining order, according to Cox.

EMW was founded in the 1980s, according to the complaint. In addition to providing both medical and surgical abortions to women, the center provides reproductive health care for women.

The loss of the center would result in a loss of reproductive freedom in Kentucky, according to Cox, and could have national ramifications.

“I think it is sort of the end game for all of this legislation that’s being adopted around the country and that is to shut down all clinics that provide abortions,” Cox said. “Throughout the country, people who are opposed to abortions are coming up with all manner of regulatory burdens that have nothing to do with the health of the women and everything to do with the politics of the moment.”