44D2020237 CLIA NUMBER - HEALTHSTAR PHYSICIANS DBA PROVIDENCE CLINIC

Laboratory Demographics

  • CLIA Code: 44D2020237
  • Facility Name: HEALTHSTAR PHYSICIANS DBA PROVIDENCE CLINIC
  • Facility Address: 220 DR MARTIN LUTHER KING PKWY
    MORRISTOWN, TN
    ZIP 37813
  • Facility Phone: 423 587-1987
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL DILLARD
  • NPI Number: 1366008153
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2020237
LAB Type Physician Office
Facility Name HEALTHSTAR PHYSICIANS DBA PROVIDENCE CLINIC
Street 220 DR MARTIN LUTHER KING PKWY
City MORRISTOWN
State TN
ZIP 37813
Phone 423 587-1987
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Physician Office
Lab Director MICHAEL DILLARD

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