44D2147935 CLIA NUMBER - RIVERSIDE VILLAGE CLINIC

Laboratory Demographics

  • CLIA Code: 44D2147935
  • Facility Name: RIVERSIDE VILLAGE CLINIC
  • Facility Address: 1406 MCGAVOCK PIKE SUITE B
    NASHVILLE, TN
    ZIP 37216
  • Facility Phone: 615 589-8652
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON L. BOYLAN
  • NPI Number: 1336429018
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2147935
LAB Type Physician Office
Facility Name RIVERSIDE VILLAGE CLINIC
Street 1406 MCGAVOCK PIKE SUITE B
City NASHVILLE
State TN
ZIP 37216
Phone 615 589-8652
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director JASON L. BOYLAN

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