44D2164318 CLIA NUMBER - BOTTS DIABETES & ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 44D2164318
  • Facility Name: BOTTS DIABETES & ENDOCRINOLOGY
  • Facility Address: 1420 W BADDOUR PKWY, SUITE 200
    LEBANON, TN
    ZIP 37087
  • Facility Phone: 615 444-4126
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: DR. JOHN INTERLANDI
  • NPI Number: 1477044717
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2164318
LAB Type Practitioner Other
Facility Name BOTTS DIABETES & ENDOCRINOLOGY
Street 1420 W BADDOUR PKWY, SUITE 200
City LEBANON
State TN
ZIP 37087
Phone 615 444-4126
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 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Practitioner Other
Lab Director DR. JOHN INTERLANDI

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