44D0965624 CLIA NUMBER - PEDIATRIC CHOICE CLINIC

Laboratory Demographics

  • CLIA Code: 44D0965624
  • Facility Name: PEDIATRIC CHOICE CLINIC
  • Facility Address: 136 MOUNTAIN PERKINS LANE, SUITE 2
    JACKSBORO, TN
    ZIP 37757
  • Facility Phone: 865 986-1400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SYED AMER
  • NPI Number: 1518112911
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 44D0965624
LAB Type Physician Office
Facility Name PEDIATRIC CHOICE CLINIC
Street 136 MOUNTAIN PERKINS LANE, SUITE 2
City JACKSBORO
State TN
ZIP 37757
Phone 865 986-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Physician Office
Lab Director DR. SYED AMER

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