44D2036172 CLIA NUMBER - PREMISE HEALTH OF TENNESSEE MEDICAL, PC

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Laboratory Demographics

CLIA Number: 44D2036172

Facility Name: PREMISE HEALTH OF TENNESSEE MEDICAL, PC

Facility Address:
1748 W ANDREW JACKSON HWY
MORRISTOWN, TN
ZIP 37814
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Facility Phone Number: 423 597-6077

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548470057

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	44D2036172
LAB Type	Physician Office
Facility Name	PREMISE HEALTH OF TENNESSEE MEDICAL, PC
Street	1748 W ANDREW JACKSON HWY
City	MORRISTOWN
State	TN
ZIP	37814
Phone	423 597-6077
CertificateType	4
CertificateEffectiveDate	2/2/2024
CertificateExpirationDate	2/1/2026
FacilityType	Waiver

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