44D2254307 CLIA NUMBER - MCDOWELL OUTPATIENT & PHP

Laboratory Demographics

  • CLIA Code: 44D2254307
  • Facility Name: MCDOWELL OUTPATIENT & PHP
  • Facility Address: 103 VOLUM
    DYERSBURG, TN
    ZIP 38024
  • Facility Phone: 731 286-2861
  • Facility Type: Other - OUTPATIENT PORTAL
  • Facility Type: Waiver
  • Lab Director: ROXANNE BRUNDIGE
  • NPI Number: 1083634596
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D2254307
LAB Type Other - OUTPATIENT PORTAL
Facility Name MCDOWELL OUTPATIENT & PHP
Street 103 VOLUM
City DYERSBURG
State TN
ZIP 38024
Phone 731 286-2861
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Other - OUTPATIENT PORTAL
Lab Director ROXANNE BRUNDIGE

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