44D2035531 CLIA NUMBER - PASSPORT HEALTH

Laboratory Demographics

  • CLIA Code: 44D2035531
  • Facility Name: PASSPORT HEALTH
  • Facility Address: 4515 POPLAR AVE, SUITE 131
    MEMPHIS, TN
    ZIP 38117
  • Facility Phone: 901 681-2700
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: TONYA PARSON
  • NPI Number: 1366797276
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2035531
LAB Type Mobile Laboratory
Facility Name PASSPORT HEALTH
Street 4515 POPLAR AVE, SUITE 131
City MEMPHIS
State TN
ZIP 38117
Phone 901 681-2700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Mobile Laboratory
Lab Director TONYA PARSON

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This page was last updated on: 3/20/2025