44D2148973 CLIA NUMBER - AMG HILLSIDE, LLC DBA SOUTHERN TENNESSEE PRIMARY CARE CORNERSVILLE

Laboratory Demographics

  • CLIA Code: 44D2148973
  • Facility Name: AMG HILLSIDE, LLC DBA SOUTHERN TENNESSEE PRIMARY CARE CORNERSVILLE
  • Facility Address: 2291 CORNERSVILLE HWY
    LEWISBURG, TN
    ZIP 37091
  • Facility Phone: 931 288-8031
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALICIA HOLT
  • NPI Number: 1720449572
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 44D2148973
LAB Type Physician Office
Facility Name AMG HILLSIDE, LLC DBA SOUTHERN TENNESSEE PRIMARY CARE CORNERSVILLE
Street 2291 CORNERSVILLE HWY
City LEWISBURG
State TN
ZIP 37091
Phone 931 288-8031
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Physician Office
Lab Director ALICIA HOLT

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