44D2266569 CLIA NUMBER - NITEOWL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 44D2266569
  • Facility Name: NITEOWL PEDIATRICS
  • Facility Address: 9219 LEE HIGHWAY, SUITE 103
    OOLTEWAH, TN
    ZIP 37363
  • Facility Phone: 423 648-6483
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TODD L. HOLD
  • NPI Number: 1871887430
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 44D2266569
LAB Type Physician Office
Facility Name NITEOWL PEDIATRICS
Street 9219 LEE HIGHWAY, SUITE 103
City OOLTEWAH
State TN
ZIP 37363
Phone 423 648-6483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director TODD L. HOLD

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