44D0976124 CLIA NUMBER - OCCUPATIONAL MEDICINE & URGENT CARE CLINIC

Laboratory Demographics

CLIA Number: 44D0976124

Facility Name: OCCUPATIONAL MEDICINE & URGENT CARE CLINIC

Facility Address:
321 QUECREEK CIRCLE
SMYRNA, TN
ZIP 37167
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Facility Phone Number: 615 355-1620

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053887703

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D0976124
LAB Type	Physician Office
Facility Name	OCCUPATIONAL MEDICINE & URGENT CARE CLINIC
Street	321 QUECREEK CIRCLE
City	SMYRNA
State	TN
ZIP	37167
Phone	615 355-1620
CertificateType	4
CertificateEffectiveDate	7/25/2022
CertificateExpirationDate	7/24/2024
FacilityType	Waiver

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