44D1071907 CLIA NUMBER - APPALACHIAN FAMILY CARE FOUNTAIN PLACE SUITE 2E

Laboratory Demographics

  • CLIA Code: 44D1071907
  • Facility Name: APPALACHIAN FAMILY CARE FOUNTAIN PLACE SUITE 2E
  • Facility Address: 1009 LARK STREET STE 1A
    JOHNSON CITY, TN
    ZIP 37604
  • Facility Phone: 423 282-2516
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEFFREY SCHOONDYKE
  • NPI Number: 1508231572
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D1071907
LAB Type Physician Office
Facility Name APPALACHIAN FAMILY CARE FOUNTAIN PLACE SUITE 2E
Street 1009 LARK STREET STE 1A
City JOHNSON CITY
State TN
ZIP 37604
Phone 423 282-2516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2023
Certificate Expiration Date 8/5/2025
Facility Type Physician Office
Lab Director DR. JEFFREY SCHOONDYKE

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This page was last updated on: 6/4/2025