44D2189225 CLIA NUMBER - KINGSTON SPRINGS PHARMACY

Laboratory Demographics

  • CLIA Code: 44D2189225
  • Facility Name: KINGSTON SPRINGS PHARMACY
  • Facility Address: 111 W KINGSTON SPRINGS ROAD SUITE 103
    KINGSTON SPRINGS, TN
    ZIP 37082
  • Facility Phone: 615 952-3690
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTY GENTRY
  • NPI Number: 1629177555
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2189225
LAB Type Pharmacy
Facility Name KINGSTON SPRINGS PHARMACY
Street 111 W KINGSTON SPRINGS ROAD SUITE 103
City KINGSTON SPRINGS
State TN
ZIP 37082
Phone 615 952-3690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Pharmacy
Lab Director MARTY GENTRY

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