44D0311447 CLIA NUMBER - CHARLES H WILKENS MD PC

Laboratory Demographics

  • CLIA Code: 44D0311447
  • Facility Name: CHARLES H WILKENS MD PC
  • Facility Address: 131 HOSPITAL LANE
    JELLICO, TN
    ZIP 37762
  • Facility Phone: 423 784-7269
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DARRYL J. WILKENS
  • NPI Number: 1790856102
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 44D0311447
LAB Type Physician Office
Facility Name CHARLES H WILKENS MD PC
Street 131 HOSPITAL LANE
City JELLICO
State TN
ZIP 37762
Phone 423 784-7269
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 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Physician Office
Lab Director DARRYL J. WILKENS

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