44D0659298 CLIA NUMBER - PINE MEADOWS HEALTHCARE & REHABILITATN

Laboratory Demographics

  • CLIA Code: 44D0659298
  • Facility Name: PINE MEADOWS HEALTHCARE & REHABILITATN
  • Facility Address: 700 NUCKOLLS ROAD
    BOLIVAR, TN
    ZIP 38008
  • Facility Phone: 901 658-4707
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CONNIE PICKARD RN
  • NPI Number: 1316018286
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D0659298
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PINE MEADOWS HEALTHCARE & REHABILITATN
Street 700 NUCKOLLS ROAD
City BOLIVAR
State TN
ZIP 38008
Phone 901 658-4707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CONNIE PICKARD RN

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