44D2172373 CLIA NUMBER - PB OUTPATIENT SERVICES, LLC DBA THE RANCH TENNESSEE

Laboratory Demographics

  • CLIA Code: 44D2172373
  • Facility Name: PB OUTPATIENT SERVICES, LLC DBA THE RANCH TENNESSEE
  • Facility Address: 1637 BOYCE ROAD
    NUNNELLY, TN
    ZIP 37137
  • Facility Phone: 931 729-9631
  • Facility Type: Other - DRUG TREATMENT PROGRAM
  • Facility Type: Waiver
  • Lab Director: BRIAN FULLER
  • NPI Number: 1114404530
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D2172373
LAB Type Other - DRUG TREATMENT PROGRAM
Facility Name PB OUTPATIENT SERVICES, LLC DBA THE RANCH TENNESSEE
Street 1637 BOYCE ROAD
City NUNNELLY
State TN
ZIP 37137
Phone 931 729-9631
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Other - DRUG TREATMENT PROGRAM
Lab Director BRIAN FULLER

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