44D0914968 CLIA NUMBER - LAWRENCE RICHARD JACKSON JR MD

Laboratory Demographics

  • CLIA Code: 44D0914968
  • Facility Name: LAWRENCE RICHARD JACKSON JR MD
  • Facility Address: 425 HIGHWAY 13 SOUTH
    WAVERLY, TN
    ZIP 37185
  • Facility Phone: 615 296-3555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAWRENCE R. JACKSON JR MD
  • NPI Number: 1386794816
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D0914968
LAB Type Physician Office
Facility Name LAWRENCE RICHARD JACKSON JR MD
Street 425 HIGHWAY 13 SOUTH
City WAVERLY
State TN
ZIP 37185
Phone 615 296-3555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Physician Office
Lab Director LAWRENCE R. JACKSON JR MD

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