44D2271402 CLIA NUMBER - MICHAEL WALL PC

Laboratory Demographics

  • CLIA Code: 44D2271402
  • Facility Name: MICHAEL WALL PC
  • Facility Address: 362 HIGH STREET
    MARYVILLE, TN
    ZIP 37804
  • Facility Phone: 865 413-1589
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. WALL
  • NPI Number: 1023727633
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2271402
LAB Type Practitioner Other
Facility Name MICHAEL WALL PC
Street 362 HIGH STREET
City MARYVILLE
State TN
ZIP 37804
Phone 865 413-1589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2024
Certificate Expiration Date 11/1/2026
Facility Type Practitioner Other
Lab Director MICHAEL D. WALL

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