44D0701640 CLIA NUMBER - FORT LOUDON FAMILY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 44D0701640
  • Facility Name: FORT LOUDON FAMILY MEDICAL CENTER
  • Facility Address: 1018 HWY 321 N
    LENOIR CITY, TN
    ZIP 37771
  • Facility Phone: 865 986-4450
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. GAIL MARIE WALTER
  • NPI Number: 1972611515
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 44D0701640
LAB Type Physician Office
Facility Name FORT LOUDON FAMILY MEDICAL CENTER
Street 1018 HWY 321 N
City LENOIR CITY
State TN
ZIP 37771
Phone 865 986-4450
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 Physician Office
Lab Director DR. GAIL MARIE WALTER

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