44D0310936 CLIA NUMBER - GORDON MOUGHON MD

Laboratory Demographics

  • CLIA Code: 44D0310936
  • Facility Name: GORDON MOUGHON MD
  • Facility Address: 630 ONEEGA SUITE B
    ERWIN, TN
    ZIP 37650
  • Facility Phone: 423 743-6169
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GORDON W. MOUGHON
  • NPI Number: 1376559070
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D0310936
LAB Type Physician Office
Facility Name GORDON MOUGHON MD
Street 630 ONEEGA SUITE B
City ERWIN
State TN
ZIP 37650
Phone 423 743-6169
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director GORDON W. MOUGHON

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