44D2297564 CLIA NUMBER - FREEDOM FAMILY MEDICAL CLINIC LLC

Laboratory Demographics

CLIA Number: 44D2297564

Facility Name: FREEDOM FAMILY MEDICAL CLINIC LLC

Facility Address:
216 WEST PLEASANT AVE
COVINGTON, TN
ZIP 38019
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Facility Phone Number: 901 664-2502

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1821864653

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	44D2297564
LAB Type	Physician Office
Facility Name	FREEDOM FAMILY MEDICAL CLINIC LLC
Street	216 WEST PLEASANT AVE
City	COVINGTON
State	TN
ZIP	38019
Phone	901 664-2502
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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