44D2284695 CLIA NUMBER - NORTHSIDE MEDICAL PROFESSIONALS, PC

Laboratory Demographics

  • CLIA Code: 44D2284695
  • Facility Name: NORTHSIDE MEDICAL PROFESSIONALS, PC
  • Facility Address: 641 E COMMERCE ST
    LEWISBURG, TN
    ZIP 37091
  • Facility Phone: 931 540-4210
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHAWN N. GENTRY
  • NPI Number: 1588420814
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2284695
LAB Type Physician Office
Facility Name NORTHSIDE MEDICAL PROFESSIONALS, PC
Street 641 E COMMERCE ST
City LEWISBURG
State TN
ZIP 37091
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 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Physician Office
Lab Director DR. SHAWN N. GENTRY

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