44D2302812 CLIA NUMBER - PINNACLE DERMATOLOGY- MT JULIET

Laboratory Demographics

  • CLIA Code: 44D2302812
  • Facility Name: PINNACLE DERMATOLOGY- MT JULIET
  • Facility Address: 650 S MT JULIET RD, SUITE 100
    MOUNT JULIET, TN
    ZIP 37122
  • Facility Phone: 615 553-2016
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES TIDWELL
  • NPI Number: 1174835763
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D2302812
LAB Type Physician Office
Facility Name PINNACLE DERMATOLOGY- MT JULIET
Street 650 S MT JULIET RD, SUITE 100
City MOUNT JULIET
State TN
ZIP 37122
Phone 615 553-2016
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Physician Office
Lab Director JAMES TIDWELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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