44D2240097 CLIA NUMBER - GALEN MEDICAL GROUP DBA GALEN DERMATOLOGY NORTH

Laboratory Demographics

  • CLIA Code: 44D2240097
  • Facility Name: GALEN MEDICAL GROUP DBA GALEN DERMATOLOGY NORTH
  • Facility Address: 1008 EXECUTIVE DRIVE, SUITE 104
    HIXSON, TN
    ZIP 37343
  • Facility Phone: 423 497-5363
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ABIGAIL RUSSELL
  • NPI Number: 1346250057
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2240097
LAB Type Physician Office
Facility Name GALEN MEDICAL GROUP DBA GALEN DERMATOLOGY NORTH
Street 1008 EXECUTIVE DRIVE, SUITE 104
City HIXSON
State TN
ZIP 37343
Phone 423 497-5363
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 8/8/2025
Certificate Expiration Date 8/7/2027
Facility Type Physician Office
Lab Director ABIGAIL RUSSELL

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