44D0311462 CLIA NUMBER - THOMAS BODUCH MD

Laboratory Demographics

  • CLIA Code: 44D0311462
  • Facility Name: THOMAS BODUCH MD
  • Facility Address: 314 EAST SPRING STREET
    KINGSTON, TN
    ZIP 37763
  • Facility Phone: 423 376-1212
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS F. BODUCH MD
  • NPI Number: 1770588741
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 44D0311462
LAB Type Physician Office
Facility Name THOMAS BODUCH MD
Street 314 EAST SPRING STREET
City KINGSTON
State TN
ZIP 37763
Phone 423 376-1212
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 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director THOMAS F. BODUCH MD

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