44D0967781 CLIA NUMBER - HOMETOWN PEDIATRIC JEFFERSON CITY MEDICAL PRACTICE

Laboratory Demographics

  • CLIA Code: 44D0967781
  • Facility Name: HOMETOWN PEDIATRIC JEFFERSON CITY MEDICAL PRACTICE
  • Facility Address: 123 MOSSY CREEK DR
    JEFFERSON CITY, TN
    ZIP 37760
  • Facility Phone: 865 475-5377
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. CASEY MOSS
  • NPI Number: 1285132845
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 44D0967781
LAB Type Physician Office
Facility Name HOMETOWN PEDIATRIC JEFFERSON CITY MEDICAL PRACTICE
Street 123 MOSSY CREEK DR
City JEFFERSON CITY
State TN
ZIP 37760
Phone 865 475-5377
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Physician Office
Lab Director DR. CASEY MOSS

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