44D2105050 CLIA NUMBER - GIBBS FAMILY PRACTICE, LLC

Laboratory Demographics

  • CLIA Code: 44D2105050
  • Facility Name: GIBBS FAMILY PRACTICE, LLC
  • Facility Address: 7331 TAZEWELL PIKE
    CORRYTON, TN
    ZIP 37721
  • Facility Phone: 865 806-2577
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOSIE CORUM
  • NPI Number: 1457726374
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2105050
LAB Type Practitioner Other
Facility Name GIBBS FAMILY PRACTICE, LLC
Street 7331 TAZEWELL PIKE
City CORRYTON
State TN
ZIP 37721
Phone 865 806-2577
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Practitioner Other
Lab Director JOSIE CORUM

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