44D0908402 CLIA NUMBER - CONCORD MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 44D0908402
  • Facility Name: CONCORD MEDICAL CENTER
  • Facility Address: 10215 KINGSTON PK STE 100
    KNOXVILLE, TN
    ZIP 37922
  • Facility Phone: 865 691-0733
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. CARABETH W. RUSSELL
  • NPI Number: 1215016506
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D0908402
LAB Type Physician Office
Facility Name CONCORD MEDICAL CENTER
Street 10215 KINGSTON PK STE 100
City KNOXVILLE
State TN
ZIP 37922
Phone 865 691-0733
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 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Physician Office
Lab Director DR. CARABETH W. RUSSELL

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