44D2031426 CLIA NUMBER - NORTH MEMPHIS MEDICAL CLINIC

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Laboratory Demographics

CLIA Number: 44D2031426

Facility Name: NORTH MEMPHIS MEDICAL CLINIC

Facility Address:
3950 NEW COVINGTON PK STE 130
MEMPHIS, TN
ZIP 38128
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Facility Phone Number: 901 388-0404

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1629370648

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	44D2031426
LAB Type	Physician Office
Facility Name	NORTH MEMPHIS MEDICAL CLINIC
Street	3950 NEW COVINGTON PK STE 130
City	MEMPHIS
State	TN
ZIP	38128
Phone	901 388-0404
CertificateType	4
CertificateEffectiveDate	10/19/2023
CertificateExpirationDate	10/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024