44D1004120 CLIA NUMBER - BLOUNT MEMORIAL PHYSICIAN GROUP, INC

Laboratory Demographics

  • CLIA Code: 44D1004120
  • Facility Name: BLOUNT MEMORIAL PHYSICIAN GROUP, INC
  • Facility Address: 720 FOOTHILLS MALL DRIVE
    MARYVILLE, TN
    ZIP 37801
  • Facility Phone: 865 342-8100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER S. BARBER
  • NPI Number: 1699710194
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D1004120
LAB Type Physician Office
Facility Name BLOUNT MEMORIAL PHYSICIAN GROUP, INC
Street 720 FOOTHILLS MALL DRIVE
City MARYVILLE
State TN
ZIP 37801
Phone 865 342-8100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Physician Office
Lab Director CHRISTOPHER S. BARBER

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