45D0477913 CLIA NUMBER - SPARKS CLINIC

Laboratory Demographics

  • CLIA Code: 45D0477913
  • Facility Name: SPARKS CLINIC
  • Facility Address: 103 N FIRST STREET
    ROCKWALL, TX
    ZIP 75087
  • Facility Phone: 972 771-5366
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHAEL R. JACKSON
  • NPI Number: 1841214467
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0477913
LAB Type Physician Office
Facility Name SPARKS CLINIC
Street 103 N FIRST STREET
City ROCKWALL
State TX
ZIP 75087
Phone 972 771-5366
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Physician Office
Lab Director MICHAEL R. JACKSON

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This page was last updated on: 9/29/2025