44D2301779 CLIA NUMBER - MAGNOLIA MEADOWS, LLC

Laboratory Demographics

  • CLIA Code: 44D2301779
  • Facility Name: MAGNOLIA MEADOWS, LLC
  • Facility Address: 1750 HALLS CREEK RD
    WAVERLY, TN
    ZIP 37185
  • Facility Phone: 931 299-0161
  • Facility Type: Other - BEHAVIORAL HEALTH RESIDEN
  • Facility Type: Waiver
  • Lab Director: CONNIE MAZZA
  • NPI Number: 1487335857
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D2301779
LAB Type Other - BEHAVIORAL HEALTH RESIDEN
Facility Name MAGNOLIA MEADOWS, LLC
Street 1750 HALLS CREEK RD
City WAVERLY
State TN
ZIP 37185
Phone 931 299-0161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Other - BEHAVIORAL HEALTH RESIDEN
Lab Director CONNIE MAZZA

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