45D0993960 CLIA NUMBER - SLP DIBOLL, LLC DBA DIBOLL NURSING AND REHAB

Laboratory Demographics

  • CLIA Code: 45D0993960
  • Facility Name: SLP DIBOLL, LLC DBA DIBOLL NURSING AND REHAB
  • Facility Address: 900 SOUTH TEMPLE DR
    DIBOLL, TX
    ZIP 75941
  • Facility Phone: 936 829-5501
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BERTINA D. MILLER
  • NPI Number: 1942818489
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D0993960
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SLP DIBOLL, LLC DBA DIBOLL NURSING AND REHAB
Street 900 SOUTH TEMPLE DR
City DIBOLL
State TX
ZIP 75941
Phone 936 829-5501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BERTINA D. MILLER

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