44D0949980 CLIA NUMBER - WHITEVILLE CORRECTIONAL FACILITY

Laboratory Demographics

CLIA Number: 44D0949980

Facility Name: WHITEVILLE CORRECTIONAL FACILITY

Facility Address:
1440 UNION SPRINGS RD
WHITEVILLE, TN
ZIP 38075
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Facility Phone Number: 731 254-9400

Facility Type: Prison

Certificate Type: Waiver

NPI Number: 1073754636

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	44D0949980
LAB Type	Prison
Facility Name	WHITEVILLE CORRECTIONAL FACILITY
Street	1440 UNION SPRINGS RD
City	WHITEVILLE
State	TN
ZIP	38075
Phone	731 254-9400
CertificateType	4
CertificateEffectiveDate	8/17/2022
CertificateExpirationDate	8/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024