44D2255899 CLIA NUMBER - EAST TENNESSEE PLASTIC SURGERY, PC

Laboratory Demographics

  • CLIA Code: 44D2255899
  • Facility Name: EAST TENNESSEE PLASTIC SURGERY, PC
  • Facility Address: 9430 PARK WEST BLVD, SUITE 240
    KNOXVILLE, TN
    ZIP 37923
  • Facility Phone: 865 694-9886
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY S. WILSON
  • NPI Number: 1578687372
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 44D2255899
LAB Type Physician Office
Facility Name EAST TENNESSEE PLASTIC SURGERY, PC
Street 9430 PARK WEST BLVD, SUITE 240
City KNOXVILLE
State TN
ZIP 37923
Phone 865 694-9886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Physician Office
Lab Director TIMOTHY S. WILSON

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