44D2278030 CLIA NUMBER - NORTHSIDE MEDICAL PROFESSIONALS

Laboratory Demographics

  • CLIA Code: 44D2278030
  • Facility Name: NORTHSIDE MEDICAL PROFESSIONALS
  • Facility Address: 2656 US- 43 NORTH
    LAWRENCEBURG, TN
    ZIP 38464
  • Facility Phone: 931 540-4210
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAWN N. GENTRY
  • NPI Number: 1295044097
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2278030
LAB Type Physician Office
Facility Name NORTHSIDE MEDICAL PROFESSIONALS
Street 2656 US- 43 NORTH
City LAWRENCEBURG
State TN
ZIP 38464
Phone 931 540-4210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Physician Office
Lab Director SHAWN N. GENTRY

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