44D1014587 CLIA NUMBER - VIP MIDSOUTH LLC DBA CHILDREN'S CLINIC OF LAFAYETTE

Laboratory Demographics

  • CLIA Code: 44D1014587
  • Facility Name: VIP MIDSOUTH LLC DBA CHILDREN'S CLINIC OF LAFAYETTE
  • Facility Address: 306 WEST LOCUST STREET
    LAFAYETTE, TN
    ZIP 37083
  • Facility Phone: 615 688-7012
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MEGAN N. TACKETT
  • NPI Number: 1588247811
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D1014587
LAB Type Physician Office
Facility Name VIP MIDSOUTH LLC DBA CHILDREN'S CLINIC OF LAFAYETTE
Street 306 WEST LOCUST STREET
City LAFAYETTE
State TN
ZIP 37083
Phone 615 688-7012
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Physician Office
Lab Director DR. MEGAN N. TACKETT

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