44D2296617 CLIA NUMBER - CREEKSIDE BEHAVIORAL HEALTH, OUTPATIENT

Laboratory Demographics

  • CLIA Code: 44D2296617
  • Facility Name: CREEKSIDE BEHAVIORAL HEALTH, OUTPATIENT
  • Facility Address: 1905 AMERICAN WAY, SUITE 1002
    KINGSPORT, TN
    ZIP 37660
  • Facility Phone: 423 830-8110
  • Facility Type: Other - OUTPATIENT BEHAVIORAL HEA
  • Facility Type: Waiver
  • Lab Director: RAKESHKUMAR PATEL
  • NPI Number: 1174038749
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 44D2296617
LAB Type Other - OUTPATIENT BEHAVIORAL HEA
Facility Name CREEKSIDE BEHAVIORAL HEALTH, OUTPATIENT
Street 1905 AMERICAN WAY, SUITE 1002
City KINGSPORT
State TN
ZIP 37660
Phone 423 830-8110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Other - OUTPATIENT BEHAVIORAL HEA
Lab Director RAKESHKUMAR PATEL

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