44D0309708 CLIA NUMBER - PIKEVILLE CLINIC

Laboratory Demographics

CLIA Number: 44D0309708

Facility Name: PIKEVILLE CLINIC

Facility Address:
3062 MAIN ST
PIKEVILLE, TN
ZIP 37367
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Facility Phone Number: 423 447-2955

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316321953

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D0309708
LAB Type	Physician Office
Facility Name	PIKEVILLE CLINIC
Street	3062 MAIN ST
City	PIKEVILLE
State	TN
ZIP	37367
Phone	423 447-2955
CertificateType	4
CertificateEffectiveDate	12/21/2022
CertificateExpirationDate	12/20/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024