Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION UNIVERSITY PHYSICIANS PRACTIC
Active
Other names
CLINICAL MICROBIOLOGY LABORATORY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
DOGWOOD LANE, BLDG 119, MOUNTAIN HOME, TN 37684
(423) 439-6242
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6054
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2082
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235200676
LABS GROUP NPI
—
Enumeration date
09/25/2006
Last updated
08/22/2018
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