Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
44D0858927
|
|
Clinical laboratory number
|
|
Lab Name
|
BLACK WOLF HEALTHCARE, LLC
|
|
Laboratory Name
|
|
Lab Type
|
Skilled Nursing Facility/Nursing Facility
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
731-852-3591
|
|
Laboratory telephone number
|
|
Fax
|
731-852-2200
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
524 WEST MAIN STREET
|
|
Primary location adress line
|
|
City
|
DECATURVILLE
|
|
Primary location city name
|
|
State
|
TN
|
|
Primary location state name
|
|
Zip
|
38329
|
|
Primary location postal code
|