45D0915991 CLIA NUMBER - COLLOM AND CARNEY GALLERIA OAKS

Laboratory Demographics

  • CLIA Code: 45D0915991
  • Facility Name: COLLOM AND CARNEY GALLERIA OAKS
  • Facility Address: 2014 GALLERIA OAKS
    TEXARKANA, TX
    ZIP 75503
  • Facility Phone: 903 614-3750
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLANE A. GRAVES, MD
  • NPI Number: 1740262732
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0915991
LAB Type Physician Office
Facility Name COLLOM AND CARNEY GALLERIA OAKS
Street 2014 GALLERIA OAKS
City TEXARKANA
State TX
ZIP 75503
Phone 903 614-3750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director BLANE A. GRAVES, MD

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