45D1002115 CLIA NUMBER - ORAL & FACIAL SURGERY GROUP OF E T LLP

Laboratory Demographics

  • CLIA Code: 45D1002115
  • Facility Name: ORAL & FACIAL SURGERY GROUP OF E T LLP
  • Facility Address: 508 RUSSELL BLVD
    NACOGDOCHES, TX
    ZIP 75965
  • Facility Phone: 936 569-1111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICH L. HURST
  • NPI Number: 1487623104
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 45D1002115
LAB Type Physician Office
Facility Name ORAL & FACIAL SURGERY GROUP OF E T LLP
Street 508 RUSSELL BLVD
City NACOGDOCHES
State TX
ZIP 75965
Phone 936 569-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Physician Office
Lab Director RICH L. HURST

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