44D0860912 CLIA NUMBER - COCKE COUNTY HMA LLC DBA TENNOVA NEWPORT - 4TH STREET

Laboratory Demographics

  • CLIA Code: 44D0860912
  • Facility Name: COCKE COUNTY HMA LLC DBA TENNOVA NEWPORT - 4TH STREET
  • Facility Address: 434 4TH STREET SUITE 305
    NEWPORT, TN
    ZIP 37821
  • Facility Phone: 423 415-3330
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: TARA L. GUSTILO
  • NPI Number: 1104463322
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 44D0860912
LAB Type Rural Health Clinic
Facility Name COCKE COUNTY HMA LLC DBA TENNOVA NEWPORT - 4TH STREET
Street 434 4TH STREET SUITE 305
City NEWPORT
State TN
ZIP 37821
Phone 423 415-3330
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 TARA L. GUSTILO

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