44D2151816 CLIA NUMBER - FAITH FAMILY MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 44D2151816

Facility Name: FAITH FAMILY MEDICAL CLINIC

Facility Address:
511 E MAIN ST
BROWNSVILLE, TN
ZIP 38012
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Facility Phone Number: 731 734-2023

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003302951

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	44D2151816
LAB Type	Physician Office
Facility Name	FAITH FAMILY MEDICAL CLINIC
Street	511 E MAIN ST
City	BROWNSVILLE
State	TN
ZIP	38012
Phone	731 734-2023
CertificateType	4
CertificateEffectiveDate	7/30/2022
CertificateExpirationDate	7/29/2024
FacilityType	Waiver

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