44D2323724 CLIA NUMBER - WILLOW PEDIATRIC CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 44D2323724
  • Facility Name: WILLOW PEDIATRIC CLINIC, LLC
  • Facility Address: 1400 WILLOW DR
    MANCHESTER, TN
    ZIP 37355
  • Facility Phone: 931 450-1486
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REBECCA D. SWIGER
  • NPI Number: 1811798481
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2323724
LAB Type Physician Office
Facility Name WILLOW PEDIATRIC CLINIC, LLC
Street 1400 WILLOW DR
City MANCHESTER
State TN
ZIP 37355
Phone 931 450-1486
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Physician Office
Lab Director REBECCA D. SWIGER

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