44D1070705 CLIA NUMBER - MADISON AVENUE PHARMACY

Laboratory Demographics

  • CLIA Code: 44D1070705
  • Facility Name: MADISON AVENUE PHARMACY
  • Facility Address: 1001 W MADISON AVENUE
    ATHENS, TN
    ZIP 37303
  • Facility Phone: 423 746-2626
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FEFFRY H. WOLFENDEN
  • NPI Number: 1144358466
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1070705
LAB Type Pharmacy
Facility Name MADISON AVENUE PHARMACY
Street 1001 W MADISON AVENUE
City ATHENS
State TN
ZIP 37303
Phone 423 746-2626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Pharmacy
Lab Director FEFFRY H. WOLFENDEN

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