44D2108247 CLIA NUMBER - LAKEWOOD PLACE

Laboratory Demographics

  • CLIA Code: 44D2108247
  • Facility Name: LAKEWOOD PLACE
  • Facility Address: 1125 GROVE ST
    LOUDON, TN
    ZIP 37774
  • Facility Phone: 865 458-4123
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SHELLEY HICKS
  • NPI Number: 1720865165
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D2108247
LAB Type Assisted Living Facility
Facility Name LAKEWOOD PLACE
Street 1125 GROVE ST
City LOUDON
State TN
ZIP 37774
Phone 865 458-4123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Assisted Living Facility
Lab Director SHELLEY HICKS

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