44D1085150 CLIA NUMBER - LEBANON GENERAL PRACTICE

Laboratory Demographics

  • CLIA Code: 44D1085150
  • Facility Name: LEBANON GENERAL PRACTICE
  • Facility Address: 228 WEST MAIN STREET SUITE B
    LEBANON, TN
    ZIP 37087
  • Facility Phone: 615 453-4532
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS A. KOWAL
  • NPI Number: 1659496040
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D1085150
LAB Type Physician Office
Facility Name LEBANON GENERAL PRACTICE
Street 228 WEST MAIN STREET SUITE B
City LEBANON
State TN
ZIP 37087
Phone 615 453-4532
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Physician Office
Lab Director THOMAS A. KOWAL

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