44D2008800 CLIA NUMBER - JACKSON CLINIC, PA BOLIVAR, THE

Laboratory Demographics

  • CLIA Code: 44D2008800
  • Facility Name: JACKSON CLINIC, PA BOLIVAR, THE
  • Facility Address: 622 WEST MARKET STREET
    BOLIVAR, TN
    ZIP 38008
  • Facility Phone: 731 658-2885
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: AMY C. BARBER
  • NPI Number: 1285629386
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D2008800
LAB Type Physician Office
Facility Name JACKSON CLINIC, PA BOLIVAR, THE
Street 622 WEST MARKET STREET
City BOLIVAR
State TN
ZIP 38008
Phone 731 658-2885
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Physician Office
Lab Director AMY C. BARBER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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