JACKSON CLINIC PA LABORATORY
NPI 1376647545
Clinical Medical Laboratory in Jackson, TN

Active since September 11, 2006
616 W FOREST AVE, JACKSON, TN 38301(731) 422-0330(731) 422-0220 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jackson Clinic Pa Laboratory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON CLINIC PA LABORATORY (NPI 1376647545) is a healthcare organization registered as a clinical medical laboratory in Jackson, Tennessee and active in the NPI registry since September 2006. The organization lists Carl E Rudd, Administrator, as its authorized official.

NPPES Registry Identity

NPI1376647545
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameJACKSON CLINIC PA
Location Address616 W FOREST AVEJackson, TN 38301-3902
Mailing AddressPo Box 400Jackson, TN 38302-0400 · (731) 423-8697 · Fax (731) 422-5743
Fax(731) 422-0220
Organization SubpartNo
Authorized OfficialCarl E RuddAdministrator · (731) 422-0330
Enumeration DateSeptember 11, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1376647545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in TN · 0000003266
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
616 W FOREST AVE, Jackson, TN 38301

Other Names 1

Doing Business AsJackson Clinic Pa Laboratory

Other Identifiers 1

Other44D0315448TN · Clia

Medical Equipment Supplier Medicare DMEPOS 16

Medicare supplier enrollment and the product categories Jackson Clinic, PA carries, from the Medicare DMEPOS supplier directory.

Jackson Clinic, PA

DMEPOS supplier · Jackson, TN

Accepts Medicare assignment

Jackson Clinic, PA agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20672441
Medicare Participant SinceAugust 1, 1992
Supplier Location2863 Hwy 45 BypassJackson, TN 38305
Supplier Specialties
Pharmacy Optometrist Optician

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
616 W FOREST AVE
JACKSON, TN 38301
Nurse Practitioner (Family)
616 W FOREST AVE
JACKSON, TN 38301
Physical Therapist
616 W FOREST AVE
JACKSON, TN 38301
Urology
616 W FOREST AVE
JACKSON, TN 38301
Anesthesiology (Critical Care Medicine)
616 W FOREST AVE
JACKSON, TN 38301
Internal Medicine
616 W FOREST AVE
JACKSON, TN 38301
Physical Therapist
616 W FOREST AVE
JACKSON, TN 38301
Rehabilitation Hospital
616 W FOREST AVE
JACKSON, TN 38301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Clinic PA's NPI number?

The NPI number for Jackson Clinic PA is 1376647545. It was assigned to this organization in the NPPES registry on September 11, 2006. The provider is doing business as Jackson Clinic PA Laboratory.

Where is Jackson Clinic PA located?

Jackson Clinic PA is located at 616 W Forest Ave, Jackson, TN 38301. The listed phone number is (731) 422-0330.

What is Jackson Clinic PA's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Jackson Clinic PA accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Jackson Clinic, PA accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Jackson Clinic PA was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.