44D2145406 CLIA NUMBER - DELTA CLINIC

Laboratory Demographics

CLIA Number: 44D2145406

Facility Name: DELTA CLINIC

Facility Address:
3441 RIDGECREST ROAD EXT
JACKSON, TN
ZIP 38305
Get Directions

Facility Phone Number: 731 541-5902

Facility Type: Industrial

Certificate Type: Waiver

NPI Number: 1578004453

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	44D2145406
LAB Type	Industrial
Facility Name	DELTA CLINIC
Street	3441 RIDGECREST ROAD EXT
City	JACKSON
State	TN
ZIP	38305
Phone	731 541-5902
CertificateType	4
CertificateEffectiveDate	3/6/2024
CertificateExpirationDate	3/5/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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