44D1009211 CLIA NUMBER - AMBULATORY SURGICAL ASOCIATES LLC

Laboratory Demographics

CLIA Number: 44D1009211

Facility Name: AMBULATORY SURGICAL ASOCIATES LLC

Facility Address:
725 KINGS LANE
TULLAHOMA, TN
ZIP 37388
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Facility Phone Number: 931 455-1976

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1356307565

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D1009211
LAB Type	Ambulatory Surgery Center
Facility Name	AMBULATORY SURGICAL ASOCIATES LLC
Street	725 KINGS LANE
City	TULLAHOMA
State	TN
ZIP	37388
Phone	931 455-1976
CertificateType	4
CertificateEffectiveDate	2/10/2023
CertificateExpirationDate	2/9/2025
FacilityType	Waiver

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