44D0874210 CLIA NUMBER - WATERS OF KINGSPORT LLC, THE

Laboratory Demographics

  • CLIA Code: 44D0874210
  • Facility Name: WATERS OF KINGSPORT LLC, THE
  • Facility Address: 100 NETHERLAND LANE
    KINGSPORT, TN
    ZIP 37660
  • Facility Phone: 423 849-0055
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER WOODBY
  • NPI Number: 1073671707
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D0874210
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WATERS OF KINGSPORT LLC, THE
Street 100 NETHERLAND LANE
City KINGSPORT
State TN
ZIP 37660
Phone 423 849-0055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIFER WOODBY

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