44D2290409 CLIA NUMBER - FAST PACE MEDICAL CLINIC, PLLC

Laboratory Demographics

CLIA Number: 44D2290409

Facility Name: FAST PACE MEDICAL CLINIC, PLLC

Facility Address:
3082 KIRBY WHITTEN ROAD
BARTLETT, TN
ZIP 38134
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Facility Phone Number: 931 253-1110

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952801334

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	44D2290409
LAB Type	Physician Office
Facility Name	FAST PACE MEDICAL CLINIC, PLLC
Street	3082 KIRBY WHITTEN ROAD
City	BARTLETT
State	TN
ZIP	38134
Phone	931 253-1110
CertificateType	4
CertificateEffectiveDate	9/26/2023
CertificateExpirationDate	9/25/2025
FacilityType	Waiver

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