44D0312109 CLIA NUMBER - CHARLES BOZEMAN MD

Laboratory Demographics

  • CLIA Code: 44D0312109
  • Facility Name: CHARLES BOZEMAN MD
  • Facility Address: 641 MIDDLE CREEK RD
    SEVIERVILLE, TN
    ZIP 37862
  • Facility Phone: 423 428-0583
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHARLES H. BOZEMAN II MD
  • NPI Number: 1275545071
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 44D0312109
LAB Type Physician Office
Facility Name CHARLES BOZEMAN MD
Street 641 MIDDLE CREEK RD
City SEVIERVILLE
State TN
ZIP 37862
Phone 423 428-0583
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 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Physician Office
Lab Director CHARLES H. BOZEMAN II MD

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This page was last updated on: 6/4/2025