44D0309791 CLIA NUMBER - PEDIATRIC CENTER OF TULLAHOMA PC THE

Laboratory Demographics

  • CLIA Code: 44D0309791
  • Facility Name: PEDIATRIC CENTER OF TULLAHOMA PC THE
  • Facility Address: 710 KINGS LANE
    TULLAHOMA, TN
    ZIP 37388
  • Facility Phone: 931 455-7044
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. RICHARD M. VAUGHN
  • NPI Number: 1063665040
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 44D0309791
LAB Type Physician Office
Facility Name PEDIATRIC CENTER OF TULLAHOMA PC THE
Street 710 KINGS LANE
City TULLAHOMA
State TN
ZIP 37388
Phone 931 455-7044
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Physician Office
Lab Director DR. RICHARD M. VAUGHN

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