44D0954064 CLIA NUMBER - MIDSTATE FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 44D0954064

Facility Name: MIDSTATE FAMILY PRACTICE

Facility Address:
1900 PATTERSON STREET, SUITE 102
NASHVILLE, TN
ZIP 37203
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Facility Phone Number: 615 329-9321

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740276450

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	44D0954064
LAB Type	Physician Office
Facility Name	MIDSTATE FAMILY PRACTICE
Street	1900 PATTERSON STREET, SUITE 102
City	NASHVILLE
State	TN
ZIP	37203
Phone	615 329-9321
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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