44D2276528 CLIA NUMBER - KIRKLAND CANCER CENTER NORTH

Laboratory Demographics

CLIA Number: 44D2276528

Facility Name: KIRKLAND CANCER CENTER NORTH

Facility Address:
322 HOSPITAL BLVD
JACKSON, TN
ZIP 38305
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Facility Phone Number: 731 541-1520

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1851983555

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	44D2276528
LAB Type	Physician Office
Facility Name	KIRKLAND CANCER CENTER NORTH
Street	322 HOSPITAL BLVD
City	JACKSON
State	TN
ZIP	38305
Phone	731 541-1520
CertificateType	2
CertificateEffectiveDate	8/3/2023
CertificateExpirationDate	8/2/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024