44D0681732 CLIA NUMBER - CHILDRENS MEDICAL GROUP PC SUMMIT MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 44D0681732
  • Facility Name: CHILDRENS MEDICAL GROUP PC SUMMIT MEDICAL CENTER
  • Facility Address: 3786 CENTRAL PIKE SUITE 130
    HERMITAGE, TN
    ZIP 37076
  • Facility Phone: 615 883-2200
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. ELIZABETH H. FAIRBANK
  • NPI Number: 1215056742
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 44D0681732
LAB Type Other
Facility Name CHILDRENS MEDICAL GROUP PC SUMMIT MEDICAL CENTER
Street 3786 CENTRAL PIKE SUITE 130
City HERMITAGE
State TN
ZIP 37076
Phone 615 883-2200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Other
Lab Director DR. ELIZABETH H. FAIRBANK

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