44D2054813 CLIA NUMBER - MORRISTOWN BG OPCO DBA DEWITT PLACE

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Laboratory Demographics

CLIA Number: 44D2054813

Facility Name: MORRISTOWN BG OPCO DBA DEWITT PLACE

Facility Address:
2131 WALTERS DR
MORRISTOWN, TN
ZIP 37814
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Facility Phone Number: 423 585-0544

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1063952430

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	44D2054813
LAB Type	Assisted Living Facility
Facility Name	MORRISTOWN BG OPCO DBA DEWITT PLACE
Street	2131 WALTERS DR
City	MORRISTOWN
State	TN
ZIP	37814
Phone	423 585-0544
CertificateType	4
CertificateEffectiveDate	2/28/2023
CertificateExpirationDate	2/27/2025
FacilityType	Waiver

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