JACKSON CLINIC PA LABORATORY
NPI 1376647545
Clinical Medical Laboratory in Jackson, TN
NPI Status: Active since September 11, 2006
Contact Information
616 W FOREST AVE
JACKSON, TN
ZIP 38301
Phone: (731) 422-0330
Fax: (731) 422-0220
- Organization
- Clinical Medical Laboratory
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 44D0910650
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-06-2027
About JACKSON CLINIC PA LABORATORY
This page provides the complete NPI Profile along with additional information for Jackson Clinic Pa Laboratory, a provider established in Jackson, Tennessee operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1376647545 assigned on September 2006. The practitioner's primary taxonomy code is 291U00000X with license number 0000003266 (TN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Jackson Clinic Pa Laboratory. The authorized official of this NPI record is Carl E Rudd (Administrator)
- NPI
- 1376647545
- Provider Legal Name
- JACKSON CLINIC PA
- Other Organization Name
- JACKSON CLINIC PA LABORATORY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 616 W FOREST AVE JACKSON, TN 38301
- Location Phone
- (731) 422-0330
- Location Fax
- (731) 422-0220
- Mailing Address
- PO BOX 400 JACKSON, TN 38302
- Mailing Phone
- (731) 423-8697
- Mailing Fax
- (731) 422-0220
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-11-2006
- Last Update Date
- 08-22-2020
- Code Navigator
Establishments like Jackson Clinic Pa Laboratory are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.
Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.
Jackson Clinic Pa Laboratory is a medicare supplier with PTAN 20672441 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Canes and/or Crutches or Orthoses: Custom Fabricated or Orthoses: Off-The-Shelf or Urological Supplies or Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses or Enteral Equipment and/or Supplies or Surgical Dressings or Diabetic Shoes and Inserts.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinical Medical Laboratory
- Taxonomy Code
- 291U00000X
- Type
- Laboratories
- License No.
- 0000003266
- License State
- TN
- Taxonomy Description
- (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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 44D0315448 | OTHER (01) | TN | CLIA |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20672441
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy, Optometrist, Optician.
- Competitive Bidding
- NO
Supplies List
- 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
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Urological Supplies - Catheters, Urinary collection devices
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
- Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D0910650
- Facility Type
- Physician Office
- Certificate Effective Date
- May 07, 2025
- Certificate Expiration Date
- May 06, 2027
- Laboratory Director
- AMY C. BARBER
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Jackson Clinic Pa Laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Reviews for JACKSON CLINIC PA LABORATORY
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1376647545, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
JACKSON, TN 38301
JACKSON, TN 38301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376647545, enumerated as an "organization" on September 11, 2006.
The provider is located at 616 W FOREST AVE JACKSON, TN 38301 and the phone number is (731) 422-0330.
Clinical Medical Laboratory with taxonomy code 291U00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
