44D2175658 CLIA NUMBER - BETHESDA CLINIC, LLC

Laboratory Demographics

CLIA Number: 44D2175658

Facility Name: BETHESDA CLINIC, LLC

Facility Address:
124 MAIN STREET
CLIFTON, TN
ZIP 38425
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Facility Phone Number: 931 676-5200

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1417505108

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2175658
LAB Type	Practitioner Other
Facility Name	BETHESDA CLINIC, LLC
Street	124 MAIN STREET
City	CLIFTON
State	TN
ZIP	38425
Phone	931 676-5200
CertificateType	3
CertificateEffectiveDate	11/26/2023
CertificateExpirationDate	11/25/2025
FacilityType	PPMP

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