44D2294666 CLIA NUMBER - VANDERBILT-INGRAM CANCER CENTER LEBANON

Laboratory Demographics

  • CLIA Code: 44D2294666
  • Facility Name: VANDERBILT-INGRAM CANCER CENTER LEBANON
  • Facility Address: 1616 WEST MAIN STREET, SUITE 101
    LEBANON, TN
    ZIP 37087
  • Facility Phone: 615 421-2891
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALEED KHALAF
  • NPI Number: 1861769606
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 44D2294666
LAB Type Physician Office
Facility Name VANDERBILT-INGRAM CANCER CENTER LEBANON
Street 1616 WEST MAIN STREET, SUITE 101
City LEBANON
State TN
ZIP 37087
Phone 615 421-2891
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Physician Office
Lab Director WALEED KHALAF

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