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44D0986736 CLIA NUMBER - PEDIATRIC PARTNERS OF MEMPHIS

Laboratory Demographics

CLIA Number: 44D0986736

Facility Name: PEDIATRIC PARTNERS OF MEMPHIS

Facility Address:
6063 MT MORIAH EXT SUITE 13
MEMPHIS, TN
ZIP 38115
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Facility Phone Number: 901 366-0080

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1215052691

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 44D0986736
LAB Type Physician Office
Facility Name PEDIATRIC PARTNERS OF MEMPHIS
Street 6063 MT MORIAH EXT SUITE 13
City MEMPHIS
State TN
ZIP 38115
Phone 901 366-0080
CertificateType 4
CertificateEffectiveDate 2/24/2023
CertificateExpirationDate 2/23/2025
FacilityType Waiver

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