44D0309672 CLIA NUMBER - COFFEE MEDICAL GROUP LLC DBA CENTER FOR FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 44D0309672
  • Facility Name: COFFEE MEDICAL GROUP LLC DBA CENTER FOR FAMILY MEDICINE
  • Facility Address: 1615 MCMINNVILLE HWY
    MANCHESTER, TN
    ZIP 37355
  • Facility Phone: (931) 728-4718
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: WILLIAM D. DANIEL
  • NPI Number: 1043537046
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D0309672
LAB Type Rural Health Clinic
Facility Name COFFEE MEDICAL GROUP LLC DBA CENTER FOR FAMILY MEDICINE
Street 1615 MCMINNVILLE HWY
City MANCHESTER
State TN
ZIP 37355
Phone 9317284718
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Rural Health Clinic
Lab Director WILLIAM D. DANIEL

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This page was last updated on: 6/29/2026