45D0941118 CLIA NUMBER - SITA M DEVULAPALLI MD PA

Laboratory Demographics

  • CLIA Code: 45D0941118
  • Facility Name: SITA M DEVULAPALLI MD PA
  • Facility Address: 903 WALNUT HILL DRIVE SUITE 1
    LONGVIEW, TX
    ZIP 75605
  • Facility Phone: 903 234-9500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SITA M. DEVULAPALLI
  • NPI Number: 1578558904
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0941118
LAB Type Physician Office
Facility Name SITA M DEVULAPALLI MD PA
Street 903 WALNUT HILL DRIVE SUITE 1
City LONGVIEW
State TX
ZIP 75605
Phone 903 234-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Physician Office
Lab Director SITA M. DEVULAPALLI

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