44D1083063 CLIA NUMBER - MUTIGEN LLC MARCUS W LEE MD

Laboratory Demographics

  • CLIA Code: 44D1083063
  • Facility Name: MUTIGEN LLC MARCUS W LEE MD
  • Facility Address: 711 NORTH ATLANTIC STREET
    TULLAHOMA, TN
    ZIP 37388
  • Facility Phone: 931 392-4169
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARCUS W. LEE MD
  • NPI Number: 1356514848
  • Taxonomy: 171W00000X - Contractor

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CLIA Record

Field Name Field Value
CLIA Number 44D1083063
LAB Type Physician Office
Facility Name MUTIGEN LLC MARCUS W LEE MD
Street 711 NORTH ATLANTIC STREET
City TULLAHOMA
State TN
ZIP 37388
Phone 931 392-4169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Physician Office
Lab Director MARCUS W. LEE MD

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