44D1094714 CLIA NUMBER - MIDDLE TENNESSEE IMAGING LLC DBA PREMIER RADIOLOGY HERMITAGE

Laboratory Demographics

  • CLIA Code: 44D1094714
  • Facility Name: MIDDLE TENNESSEE IMAGING LLC DBA PREMIER RADIOLOGY HERMITAGE
  • Facility Address: 5045 OLD HICKORY BLVD STE 100
    HERMITAGE, TN
    ZIP 37076
  • Facility Phone: 615 884-7674
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KEVIN CUNNEELY
  • NPI Number: 1578944187
  • Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities

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CLIA Record

Field Name Field Value
CLIA Number 44D1094714
LAB Type Practitioner Other
Facility Name MIDDLE TENNESSEE IMAGING LLC DBA PREMIER RADIOLOGY HERMITAGE
Street 5045 OLD HICKORY BLVD STE 100
City HERMITAGE
State TN
ZIP 37076
Phone 615 884-7674
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Practitioner Other
Lab Director KEVIN CUNNEELY

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