Organization
LABORATORY FOR KIDNEY PATHOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA H CHAVEZ (CORPORATE SECRETARY)
(615) 321-5729
Entity
Organization
Contact information
Practice address
1916 PATTERSON ST, SUITE 501, NASHVILLE, TN 37203-2120
(615) 321-5729
Mailing address
1916 PATTERSON ST, SUITE 501, NASHVILLE, TN 37203-2120
(615) 321-5729
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
0000001976
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000001976
LABORATORY LICENSE
TN
05
—
3400011
—
TN
01
—
44D03040847
CLIA
TN
01
—
800025855
LAB LICENSE
FL
Enumeration date
07/05/2005
Last updated
09/25/2023
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