44D2174926 CLIA NUMBER - TENNESSEE CANCER SPECIALISTS - ATHENS

Laboratory Demographics

CLIA Number: 44D2174926

Facility Name: TENNESSEE CANCER SPECIALISTS - ATHENS

Facility Address:
1031 WEST MADISON AVE SUITE 1
ATHENS, TN
ZIP 37303
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Facility Phone Number: 865 934-5800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538175120

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	44D2174926
LAB Type	Physician Office
Facility Name	TENNESSEE CANCER SPECIALISTS - ATHENS
Street	1031 WEST MADISON AVE SUITE 1
City	ATHENS
State	TN
ZIP	37303
Phone	865 934-5800
CertificateType	4
CertificateEffectiveDate	11/12/2023
CertificateExpirationDate	11/11/2025
FacilityType	Waiver

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