44D2156679 CLIA NUMBER - RIVERCITY FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 44D2156679
  • Facility Name: RIVERCITY FAMILY MEDICINE
  • Facility Address: 6043 SHALLOWFORD RD STE 101
    CHATTANOOGA, TN
    ZIP 37421
  • Facility Phone: 423 802-1919
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. ANTHONY G. AVITABILE
  • NPI Number: 1427554492
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2156679
LAB Type Physician Office
Facility Name RIVERCITY FAMILY MEDICINE
Street 6043 SHALLOWFORD RD STE 101
City CHATTANOOGA
State TN
ZIP 37421
Phone 423 802-1919
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Physician Office
Lab Director DR. ANTHONY G. AVITABILE

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This page was last updated on: 3/20/2025