44D2136185 CLIA NUMBER - FAST PACE MEDICAL CLINIC, PLLC

Laboratory Demographics

CLIA Number: 44D2136185

Facility Name: FAST PACE MEDICAL CLINIC, PLLC

Facility Address:
19536 ALBERTA STREET
ONEIDA, TN
ZIP 37841
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Facility Phone Number: 423 569-3278

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831854132

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2136185
LAB Type	Physician Office
Facility Name	FAST PACE MEDICAL CLINIC, PLLC
Street	19536 ALBERTA STREET
City	ONEIDA
State	TN
ZIP	37841
Phone	423 569-3278
CertificateType	4
CertificateEffectiveDate	9/5/2023
CertificateExpirationDate	9/4/2025
FacilityType	Waiver

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