44D2173207 CLIA NUMBER - LOVE WITHOUT WALLS MENTAL HEALTH CENTER

Laboratory Demographics

CLIA Number: 44D2173207

Facility Name: LOVE WITHOUT WALLS MENTAL HEALTH CENTER

Facility Address:
111 PARK STREET
ATHENS, TN
ZIP 37303
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Facility Phone Number: 423 252-0075

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619440351

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2173207
LAB Type	Physician Office
Facility Name	LOVE WITHOUT WALLS MENTAL HEALTH CENTER
Street	111 PARK STREET
City	ATHENS
State	TN
ZIP	37303
Phone	423 252-0075
CertificateType	4
CertificateEffectiveDate	10/8/2023
CertificateExpirationDate	10/7/2025
FacilityType	Waiver

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