44D2197542 CLIA NUMBER - VANDERBILT EXECUTIVE WELLNESS & CONCIERGE MED

Laboratory Demographics

  • CLIA Code: 44D2197542
  • Facility Name: VANDERBILT EXECUTIVE WELLNESS & CONCIERGE MED
  • Facility Address: 3807 CLEGHORN AVE STE 900
    NASHVILLE, TN
    ZIP 37215
  • Facility Phone: 615 936-7100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. EMILY G. KURTZ
  • NPI Number: 1427394634
  • Taxonomy: 363LC0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2197542
LAB Type Physician Office
Facility Name VANDERBILT EXECUTIVE WELLNESS & CONCIERGE MED
Street 3807 CLEGHORN AVE STE 900
City NASHVILLE
State TN
ZIP 37215
Phone 615 936-7100
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/1/2023
Certificate Expiration Date 9/30/2025
Facility Type Physician Office
Lab Director DR. EMILY G. KURTZ

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This page was last updated on: 3/20/2025