44D2237014 CLIA NUMBER - PHYSICIAN ASSOCIATE INTERDISCIPLINARY CLINIC

Laboratory Demographics

  • CLIA Code: 44D2237014
  • Facility Name: PHYSICIAN ASSOCIATE INTERDISCIPLINARY CLINIC
  • Facility Address: 4131 KIRBY PKWY, SUITE 1
    MEMPHIS, TN
    ZIP 38115
  • Facility Phone: 901 305-6766
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: MAURICE SKILLERN
  • NPI Number: 1407373210
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 44D2237014
LAB Type Community Clinic
Facility Name PHYSICIAN ASSOCIATE INTERDISCIPLINARY CLINIC
Street 4131 KIRBY PKWY, SUITE 1
City MEMPHIS
State TN
ZIP 38115
Phone 901 305-6766
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 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Community Clinic
Lab Director MAURICE SKILLERN

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