44D2105973 CLIA NUMBER - SUMMIT MEDICAL GROUP OF COOKEVILLE DBA MEDICAL PRACTICE

Laboratory Demographics

  • CLIA Code: 44D2105973
  • Facility Name: SUMMIT MEDICAL GROUP OF COOKEVILLE DBA MEDICAL PRACTICE
  • Facility Address: 128 N WHITNEY AVE
    COOKEVILLE, TN
    ZIP 38501
  • Facility Phone: 931 783-4600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. LORA P. WORSHAM
  • NPI Number: 1588362164
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D2105973
LAB Type Physician Office
Facility Name SUMMIT MEDICAL GROUP OF COOKEVILLE DBA MEDICAL PRACTICE
Street 128 N WHITNEY AVE
City COOKEVILLE
State TN
ZIP 38501
Phone 931 783-4600
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Physician Office
Lab Director DR. LORA P. WORSHAM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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