44D2284607 CLIA NUMBER - SOUTHERN TENNESSEE PREMIER WOMEN'S OB-GYN

Laboratory Demographics

CLIA Number: 44D2284607

Facility Name: SOUTHERN TENNESSEE PREMIER WOMEN'S OB-GYN

Facility Address:
155 HOSPITAL RD STE C
WINCHESTER, TN
ZIP 37398
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Facility Phone Number: 931 962-3297

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487680732

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2284607
LAB Type	Physician Office
Facility Name	SOUTHERN TENNESSEE PREMIER WOMEN'S OB-GYN
Street	155 HOSPITAL RD STE C
City	WINCHESTER
State	TN
ZIP	37398
Phone	931 962-3297
CertificateType	4
CertificateEffectiveDate	6/27/2023
CertificateExpirationDate	6/26/2025
FacilityType	Waiver

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