44D2172188 CLIA NUMBER - AMG-HILLSIDE DBA SOUTHERN TENNESSEE PRIMARY CARE ARDMORE

Laboratory Demographics

CLIA Number: 44D2172188

Facility Name: AMG-HILLSIDE DBA SOUTHERN TENNESSEE PRIMARY CARE ARDMORE

Facility Address:
26032 MAIN STREET
ARDMORE, TN
ZIP 38449
Get Directions

Facility Phone Number: 931 427-3020

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1700208618

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	44D2172188
LAB Type	Physician Office
Facility Name	AMG-HILLSIDE DBA SOUTHERN TENNESSEE PRIMARY CARE ARDMORE
Street	26032 MAIN STREET
City	ARDMORE
State	TN
ZIP	38449
Phone	931 427-3020
CertificateType	3
CertificateEffectiveDate	9/17/2023
CertificateExpirationDate	9/16/2025
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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