44D2102639 CLIA NUMBER - FAST PACE MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 44D2102639

Facility Name: FAST PACE MEDICAL CLINIC

Facility Address:
2401 DECHERD BLVD
WINCHESTER, TN
ZIP 37398
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Facility Phone Number: 615 988-1571

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639679913

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2102639
LAB Type	Physician Office
Facility Name	FAST PACE MEDICAL CLINIC
Street	2401 DECHERD BLVD
City	WINCHESTER
State	TN
ZIP	37398
Phone	615 988-1571
CertificateType	4
CertificateEffectiveDate	9/28/2023
CertificateExpirationDate	9/27/2025
FacilityType	Waiver

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