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

Laboratory Demographics

  • CLIA Code: 44D2172188
  • Facility Name: AMG-HILLSIDE DBA SOUTHERN TENNESSEE PRIMARY CARE ARDMORE
  • Facility Address: 26032 MAIN STREET
    ARDMORE, TN
    ZIP 38449
  • Facility Phone: 931 427-3020
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: HOLLY CLEM
  • NPI Number: 1700208618
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2172188
LAB Type Rural Health Clinic
Facility Name AMG-HILLSIDE DBA SOUTHERN TENNESSEE PRIMARY CARE ARDMORE
Street 26032 MAIN STREET
City ARDMORE
State TN
ZIP 38449
Phone 931 427-3020
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 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Rural Health Clinic
Lab Director HOLLY CLEM

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