44D0696156 CLIA NUMBER - WEST TENNESSEE MEDICAL GROUP NORTHSIDE PHYSICIANS OFFICE

Laboratory Demographics

  • CLIA Code: 44D0696156
  • Facility Name: WEST TENNESSEE MEDICAL GROUP NORTHSIDE PHYSICIANS OFFICE
  • Facility Address: 31 HUGHES DRIVE
    JACKSON, TN
    ZIP 38305
  • Facility Phone: 731 668-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ELIZABETH S. LONDINO
  • NPI Number: 1083781595
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D0696156
LAB Type Physician Office
Facility Name WEST TENNESSEE MEDICAL GROUP NORTHSIDE PHYSICIANS OFFICE
Street 31 HUGHES DRIVE
City JACKSON
State TN
ZIP 38305
Phone 731 668-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Physician Office
Lab Director DR. ELIZABETH S. LONDINO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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