44D2043626 CLIA NUMBER - MAURY REGIONAL MEDICAL GROUP MDVIP

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Laboratory Demographics

CLIA Number: 44D2043626

Facility Name: MAURY REGIONAL MEDICAL GROUP MDVIP

Facility Address:
104 GLASS ST
MOUNT PLEASANT, TN
ZIP 38474
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Facility Phone Number: 931 379-7325

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1073156410

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2043626
LAB Type	Physician Office
Facility Name	MAURY REGIONAL MEDICAL GROUP MDVIP
Street	104 GLASS ST
City	MOUNT PLEASANT
State	TN
ZIP	38474
Phone	931 379-7325
CertificateType	3
CertificateEffectiveDate	7/6/2022
CertificateExpirationDate	7/5/2024
FacilityType	PPMP

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