44D0313312 CLIA NUMBER - SAMUEL L BROFFITT MD

Laboratory Demographics

  • CLIA Code: 44D0313312
  • Facility Name: SAMUEL L BROFFITT MD
  • Facility Address: HWY 51 S PO BOX 784
    COVINGTON, TN
    ZIP 38019
  • Facility Phone: 901 476-4526
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAMUEL L. BROFFITT
  • NPI Number: 1790882595
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D0313312
LAB Type Physician Office
Facility Name SAMUEL L BROFFITT MD
Street HWY 51 S PO BOX 784
City COVINGTON
State TN
ZIP 38019
Phone 901 476-4526
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 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Physician Office
Lab Director SAMUEL L. BROFFITT

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