44D2292801 CLIA NUMBER - INTEGRATED SKIN INSTITUTE

Laboratory Demographics

  • CLIA Code: 44D2292801
  • Facility Name: INTEGRATED SKIN INSTITUTE
  • Facility Address: 1424 WEST BADDOUR PKWY, SUITE G
    LEBANON, TN
    ZIP 37087
  • Facility Phone: 615 314-1699
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. TEJASWI V. MUDIGONDA
  • NPI Number: 1770351041
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 44D2292801
LAB Type Physician Office
Facility Name INTEGRATED SKIN INSTITUTE
Street 1424 WEST BADDOUR PKWY, SUITE G
City LEBANON
State TN
ZIP 37087
Phone 615 314-1699
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Physician Office
Lab Director DR. TEJASWI V. MUDIGONDA

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