44D2034273 CLIA NUMBER - PROXIMA CENTURA PLLC DBA LINCOLN TREE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 44D2034273
  • Facility Name: PROXIMA CENTURA PLLC DBA LINCOLN TREE MEDICAL CLINIC
  • Facility Address: 1600 MCARTHUR ST
    MANCHESTER, TN
    ZIP 37355
  • Facility Phone: 931 723-7950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES E. ROTH
  • NPI Number: 1982972857
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2034273
LAB Type Physician Office
Facility Name PROXIMA CENTURA PLLC DBA LINCOLN TREE MEDICAL CLINIC
Street 1600 MCARTHUR ST
City MANCHESTER
State TN
ZIP 37355
Phone 931 723-7950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director JAMES E. ROTH

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