44D2077886 CLIA NUMBER - 45 URGENT CARE, PC

Laboratory Demographics

  • CLIA Code: 44D2077886
  • Facility Name: 45 URGENT CARE, PC
  • Facility Address: 149 N STAR DR
    JACKSON, TN
    ZIP 38305
  • Facility Phone: 731 554-0571
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARK W. FOWLER
  • NPI Number: 1912326539
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2077886
LAB Type Physician Office
Facility Name 45 URGENT CARE, PC
Street 149 N STAR DR
City JACKSON
State TN
ZIP 38305
Phone 731 554-0571
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Physician Office
Lab Director DR. MARK W. FOWLER

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