44D0679118 CLIA NUMBER - SOUTHERN TENNESSEE INTERNAL MEDICINE LAWRENCEBURG

Laboratory Demographics

  • CLIA Code: 44D0679118
  • Facility Name: SOUTHERN TENNESSEE INTERNAL MEDICINE LAWRENCEBURG
  • Facility Address: 184 PROSSER ROAD
    LAWRENCEBURG, TN
    ZIP 38464
  • Facility Phone: 931 762-5115
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: DR. PHOTIOS VADDILYADI
  • NPI Number: 1215144936
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 44D0679118
LAB Type Rural Health Clinic
Facility Name SOUTHERN TENNESSEE INTERNAL MEDICINE LAWRENCEBURG
Street 184 PROSSER ROAD
City LAWRENCEBURG
State TN
ZIP 38464
Phone 931 762-5115
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Rural Health Clinic
Lab Director DR. PHOTIOS VADDILYADI

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