44D2260861 CLIA NUMBER - PORTLAND MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 44D2260861
  • Facility Name: PORTLAND MEDICAL LLC
  • Facility Address: 307 SOUTH BROADWAY
    PORTLAND, TN
    ZIP 37148
  • Facility Phone: 615 323-9158
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHLEA B. LAMBERTH
  • NPI Number: 1720034226
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2260861
LAB Type Physician Office
Facility Name PORTLAND MEDICAL LLC
Street 307 SOUTH BROADWAY
City PORTLAND
State TN
ZIP 37148
Phone 615 323-9158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director ASHLEA B. LAMBERTH

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