44D2189654 CLIA NUMBER - HOLSTON MEDICAL GROUP, PC DBA SAPLING GROVE OUTPATIENT DIAGNOSTICS

Laboratory Demographics

  • CLIA Code: 44D2189654
  • Facility Name: HOLSTON MEDICAL GROUP, PC DBA SAPLING GROVE OUTPATIENT DIAGNOSTICS
  • Facility Address: 240 MEDICAL PARK BLVD, SUITE 1100
    BRISTOL, TN
    ZIP 37620
  • Facility Phone: 423 990-2440
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICK J. WHILES
  • NPI Number: 1215978945
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2189654
LAB Type Physician Office
Facility Name HOLSTON MEDICAL GROUP, PC DBA SAPLING GROVE OUTPATIENT DIAGNOSTICS
Street 240 MEDICAL PARK BLVD, SUITE 1100
City BRISTOL
State TN
ZIP 37620
Phone 423 990-2440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Physician Office
Lab Director DR. RICK J. WHILES

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