44D2170207 CLIA NUMBER - DEBRA SUE CANNON DBA CLARKSBURG FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 44D2170207
  • Facility Name: DEBRA SUE CANNON DBA CLARKSBURG FAMILY CLINIC
  • Facility Address: 37 WALLACE LANE
    YUMA, TN
    ZIP 38390
  • Facility Phone: 731 535-3114
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JOHN L. BLAKENSHIP
  • NPI Number: 1083195283
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2170207
LAB Type Physician Office
Facility Name DEBRA SUE CANNON DBA CLARKSBURG FAMILY CLINIC
Street 37 WALLACE LANE
City YUMA
State TN
ZIP 38390
Phone 731 535-3114
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 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director DR. JOHN L. BLAKENSHIP

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