44D2267521 CLIA NUMBER - HERMITAGE FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 44D2267521
  • Facility Name: HERMITAGE FAMILY PRACTICE LLC
  • Facility Address: 4243 LEBANON PIKE, SUITE A
    HERMITAGE, TN
    ZIP 37076
  • Facility Phone: 615 874-9888
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JILL WELBERN TIBBETTS
  • NPI Number: 1245983030
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2267521
LAB Type Practitioner Other
Facility Name HERMITAGE FAMILY PRACTICE LLC
Street 4243 LEBANON PIKE, SUITE A
City HERMITAGE
State TN
ZIP 37076
Phone 615 874-9888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Practitioner Other
Lab Director JILL WELBERN TIBBETTS

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