44D2138760 CLIA NUMBER - MIDTENN PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 44D2138760
  • Facility Name: MIDTENN PRIMARY CARE, LLC
  • Facility Address: 701 PARK AVE
    LEBANON, TN
    ZIP 37087
  • Facility Phone: 615 547-6699
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HELEN D. FISHER-THORNE
  • NPI Number: 1750890174
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2138760
LAB Type Physician Office
Facility Name MIDTENN PRIMARY CARE, LLC
Street 701 PARK AVE
City LEBANON
State TN
ZIP 37087
Phone 615 547-6699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Physician Office
Lab Director HELEN D. FISHER-THORNE

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