44D2276220 CLIA NUMBER - OGI WT JV LLC DBA SKYLINE ENDOSCOPY OF WEST TENNESSEE

Laboratory Demographics

  • CLIA Code: 44D2276220
  • Facility Name: OGI WT JV LLC DBA SKYLINE ENDOSCOPY OF WEST TENNESSEE
  • Facility Address: 27 MEDICAL CENTER DRIVE, BUILDING 2
    JACKSON, TN
    ZIP 38301
  • Facility Phone: 731 280-0156
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRITTAIN D. LITTLE
  • NPI Number: 1427795913
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2276220
LAB Type Ambulatory Surgery Center
Facility Name OGI WT JV LLC DBA SKYLINE ENDOSCOPY OF WEST TENNESSEE
Street 27 MEDICAL CENTER DRIVE, BUILDING 2
City JACKSON
State TN
ZIP 38301
Phone 731 280-0156
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Ambulatory Surgery Center
Lab Director BRITTAIN D. LITTLE

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