44D2136468 CLIA NUMBER - SUMMIT MEDICAL GROUP - TELLICO VILLAGE

Laboratory Demographics

  • CLIA Code: 44D2136468
  • Facility Name: SUMMIT MEDICAL GROUP - TELLICO VILLAGE
  • Facility Address: 202 DOHI DR
    LOUDON, TN
    ZIP 37774
  • Facility Phone: 865 205-3025
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. FRED B. SAMMONS
  • NPI Number: 1700302098
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2136468
LAB Type Physician Office
Facility Name SUMMIT MEDICAL GROUP - TELLICO VILLAGE
Street 202 DOHI DR
City LOUDON
State TN
ZIP 37774
Phone 865 205-3025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Physician Office
Lab Director DR. FRED B. SAMMONS

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