44D1034034 CLIA NUMBER - SPORTS, ORTHOPEDICS & SPINE

Laboratory Demographics

  • CLIA Code: 44D1034034
  • Facility Name: SPORTS, ORTHOPEDICS & SPINE
  • Facility Address: 111 STONEBRIDGE BLVD
    JACKSON, TN
    ZIP 38305
  • Facility Phone: 731 427-7888
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KEITH D. NORD MD
  • NPI Number: 1831550854
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 44D1034034
LAB Type Practitioner Other
Facility Name SPORTS, ORTHOPEDICS & SPINE
Street 111 STONEBRIDGE BLVD
City JACKSON
State TN
ZIP 38305
Phone 731 427-7888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Practitioner Other
Lab Director KEITH D. NORD MD

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