44D2170210 CLIA NUMBER - 493 INTERNAL MEDICINE PLLC

Laboratory Demographics

  • CLIA Code: 44D2170210
  • Facility Name: 493 INTERNAL MEDICINE PLLC
  • Facility Address: 493 LANTANA ROAD
    CROSSVILLE, TN
    ZIP 38555
  • Facility Phone: 931 335-9919
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. STEPHEN D. CLARK
  • NPI Number: 1356994461
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2170210
LAB Type Physician Office
Facility Name 493 INTERNAL MEDICINE PLLC
Street 493 LANTANA ROAD
City CROSSVILLE
State TN
ZIP 38555
Phone 931 335-9919
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. STEPHEN D. CLARK

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