44D1019837 CLIA NUMBER - SHELBY COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 44D1019837
  • Facility Name: SHELBY COUNTY HEALTH DEPARTMENT
  • Facility Address: 814 JEFFERSON #302
    MEMPHIS, TN
    ZIP 38105
  • Facility Phone: 901 222-9523
  • Facility Type: Other - METRO HEALTH DEPT
  • Facility Type: Microscopy
  • Lab Director: BRUCE WENDELL RANDOLPH
  • NPI Number: 1396766655
  • Taxonomy: 364SC1501X - Clinical Nurse Specialist

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CLIA Record

Field Name Field Value
CLIA Number 44D1019837
LAB Type Other - METRO HEALTH DEPT
Facility Name SHELBY COUNTY HEALTH DEPARTMENT
Street 814 JEFFERSON #302
City MEMPHIS
State TN
ZIP 38105
Phone 901 222-9523
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Other - METRO HEALTH DEPT
Lab Director BRUCE WENDELL RANDOLPH

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