44D2282299 CLIA NUMBER - EVOLVE 865

Laboratory Demographics

  • CLIA Code: 44D2282299
  • Facility Name: EVOLVE 865
  • Facility Address: 460 MEDICAL PARK DR STE 102
    LENOIR CITY, TN
    ZIP 37772
  • Facility Phone: (865) 816-3617
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JILL D. LARSON
  • NPI Number: 1760189443
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2282299
LAB Type Physician Office
Facility Name EVOLVE 865
Street 460 MEDICAL PARK DR STE 102
City LENOIR CITY
State TN
ZIP 37772
Phone 8658163617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Physician Office
Lab Director JILL D. LARSON

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This page was last updated on: 5/18/2026