44D2147271 CLIA NUMBER - WADE FAMILY MEDICINE LLC

Laboratory Demographics

CLIA Number: 44D2147271

Facility Name: WADE FAMILY MEDICINE LLC

Facility Address:
115 S MUNFORD STREET
COVINGTON, TN
ZIP 38019
Get Directions

Facility Phone Number: 901 244-4646

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1629586375

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	44D2147271
LAB Type	Practitioner Other
Facility Name	WADE FAMILY MEDICINE LLC
Street	115 S MUNFORD STREET
City	COVINGTON
State	TN
ZIP	38019
Phone	901 244-4646
CertificateType	4
CertificateEffectiveDate	4/17/2024
CertificateExpirationDate	4/16/2026
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