45D0506400 CLIA NUMBER - FOUR OAKS MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D0506400
  • Facility Name: FOUR OAKS MEDICAL CLINIC
  • Facility Address: 109 SHULT DR # 102
    COLUMBUS, TX
    ZIP 78934
  • Facility Phone: 979 732-5794
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: BART D. KLAUS
  • NPI Number: 1932158367
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0506400
LAB Type Rural Health Clinic
Facility Name FOUR OAKS MEDICAL CLINIC
Street 109 SHULT DR # 102
City COLUMBUS
State TX
ZIP 78934
Phone 979 732-5794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Rural Health Clinic
Lab Director BART D. KLAUS

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