44D2023831 CLIA NUMBER - MOUNTAIN MEDICAL SERVICES PLLC

Laboratory Demographics

  • CLIA Code: 44D2023831
  • Facility Name: MOUNTAIN MEDICAL SERVICES PLLC
  • Facility Address: 2946 WINFIELD DUNN PKWY STE 107
    KODAK, TN
    ZIP 37764
  • Facility Phone: 865 933-9950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROGER D. BARNES
  • NPI Number: 1053610717
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2023831
LAB Type Physician Office
Facility Name MOUNTAIN MEDICAL SERVICES PLLC
Street 2946 WINFIELD DUNN PKWY STE 107
City KODAK
State TN
ZIP 37764
Phone 865 933-9950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director ROGER D. BARNES

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