45D0987552 CLIA NUMBER - MARK C EIDSON

Laboratory Demographics

  • CLIA Code: 45D0987552
  • Facility Name: MARK C EIDSON
  • Facility Address: 710 E ANDERSON
    WEATHERFORD, TX
    ZIP 76086
  • Facility Phone: 817 599-9472
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK C. EIDSON MD
  • NPI Number: 1295726784
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0987552
LAB Type Physician Office
Facility Name MARK C EIDSON
Street 710 E ANDERSON
City WEATHERFORD
State TX
ZIP 76086
Phone 817 599-9472
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Physician Office
Lab Director MARK C. EIDSON MD

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