45D0725209 CLIA NUMBER - THOMAS L WILSON MD

Laboratory Demographics

  • CLIA Code: 45D0725209
  • Facility Name: THOMAS L WILSON MD
  • Facility Address: 2602 ST MICHAEL DR
    TEXARKANA, TX
    ZIP 75503
  • Facility Phone: 903 792-1216
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS L. WILSON
  • NPI Number: 1770583189
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D0725209
LAB Type Physician Office
Facility Name THOMAS L WILSON MD
Street 2602 ST MICHAEL DR
City TEXARKANA
State TX
ZIP 75503
Phone 903 792-1216
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Physician Office
Lab Director THOMAS L. WILSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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