44D2151055 CLIA NUMBER - AMG SOUTHERN TENNESSEE, LLC DBA SOUTHERN TN PRIMARY CARE

Laboratory Demographics

CLIA Number: 44D2151055

Facility Name: AMG SOUTHERN TENNESSEE, LLC DBA SOUTHERN TN PRIMARY CARE

Facility Address:
1894 COWAN HWY
WINCHESTER, TN
ZIP 37398
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Facility Phone Number: 931 967-1299

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184666489

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	44D2151055
LAB Type	Physician Office
Facility Name	AMG SOUTHERN TENNESSEE, LLC DBA SOUTHERN TN PRIMARY CARE
Street	1894 COWAN HWY
City	WINCHESTER
State	TN
ZIP	37398
Phone	931 967-1299
CertificateType	4
CertificateEffectiveDate	7/10/2022
CertificateExpirationDate	7/9/2024
FacilityType	Waiver

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