44D2073663 CLIA NUMBER - SOUTHERN SPORTS SURGICAL, LLC

Laboratory Demographics

  • CLIA Code: 44D2073663
  • Facility Name: SOUTHERN SPORTS SURGICAL, LLC
  • Facility Address: 127 SAUNDERSVILLE RD, SUITE A
    HENDERSONVILLE, TN
    ZIP 37075
  • Facility Phone: 615 418-2957
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. PAUL GRUTTER
  • NPI Number: 1295326510
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 44D2073663
LAB Type Ambulatory Surgery Center
Facility Name SOUTHERN SPORTS SURGICAL, LLC
Street 127 SAUNDERSVILLE RD, SUITE A
City HENDERSONVILLE
State TN
ZIP 37075
Phone 615 418-2957
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. PAUL GRUTTER

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