44D1079366 CLIA NUMBER - MEMPHIS RADIOLOGICAL PC DBA DIAGNOSTIC IMAGING

Laboratory Demographics

  • CLIA Code: 44D1079366
  • Facility Name: MEMPHIS RADIOLOGICAL PC DBA DIAGNOSTIC IMAGING
  • Facility Address: 6401 POPLAR AVE, SUITE 100
    MEMPHIS, TN
    ZIP 38119
  • Facility Phone: 901 685-2696
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: KRISTOPHER HORNE
  • NPI Number: 1699725812
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 44D1079366
LAB Type Mobile Laboratory
Facility Name MEMPHIS RADIOLOGICAL PC DBA DIAGNOSTIC IMAGING
Street 6401 POPLAR AVE, SUITE 100
City MEMPHIS
State TN
ZIP 38119
Phone 901 685-2696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Mobile Laboratory
Lab Director KRISTOPHER HORNE

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