44D0307008 CLIA NUMBER - VANDERBILT UNIVERSITY MEDICAL CENTER DBA VANDERBILT INTEGRATED PEDIATRICS RIVERGATE

Laboratory Demographics

  • CLIA Code: 44D0307008
  • Facility Name: VANDERBILT UNIVERSITY MEDICAL CENTER DBA VANDERBILT INTEGRATED PEDIATRICS RIVERGATE
  • Facility Address: 807 MEADOW LARK LANE
    GOODLETTSVILLE, TN
    ZIP 37072
  • Facility Phone: 615 859-6650
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY H. EIDSON
  • NPI Number: 1437498706
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 44D0307008
LAB Type Physician Office
Facility Name VANDERBILT UNIVERSITY MEDICAL CENTER DBA VANDERBILT INTEGRATED PEDIATRICS RIVERGATE
Street 807 MEADOW LARK LANE
City GOODLETTSVILLE
State TN
ZIP 37072
Phone 615 859-6650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Physician Office
Lab Director TIMOTHY H. EIDSON

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This page was last updated on: 9/29/2025