45D0482327 CLIA NUMBER - COLLOM & CARNEY WESTSIDE CLINIC

Laboratory Demographics

  • CLIA Code: 45D0482327
  • Facility Name: COLLOM & CARNEY WESTSIDE CLINIC
  • Facility Address: 815 NORTH KINGS HIGHWAY
    TEXARKANA, TX
    ZIP 75501
  • Facility Phone: 903 614-3711
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARLA ROSE MT ASCP
  • NPI Number: 1619291010
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0482327
LAB Type Physician Office
Facility Name COLLOM & CARNEY WESTSIDE CLINIC
Street 815 NORTH KINGS HIGHWAY
City TEXARKANA
State TX
ZIP 75501
Phone 903 614-3711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Physician Office
Lab Director CARLA ROSE MT ASCP

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