44D2232148 CLIA NUMBER - INDEV SUPPORTED LIVING

Laboratory Demographics

  • CLIA Code: 44D2232148
  • Facility Name: INDEV SUPPORTED LIVING
  • Facility Address: 2675 UNION AVE EXTENDED
    MEMPHIS, TN
    ZIP 38111
  • Facility Phone: 901 682-2022
  • Facility Type: Other - DIDD SUPPORTED LIVING AGE
  • Facility Type: Waiver
  • Lab Director: ANDREA WILKES
  • NPI Number: 1578089439
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 44D2232148
LAB Type Other - DIDD SUPPORTED LIVING AGE
Facility Name INDEV SUPPORTED LIVING
Street 2675 UNION AVE EXTENDED
City MEMPHIS
State TN
ZIP 38111
Phone 901 682-2022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Other - DIDD SUPPORTED LIVING AGE
Lab Director ANDREA WILKES

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