45D1016834 CLIA NUMBER - AARON C POLK JR MD FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D1016834
  • Facility Name: AARON C POLK JR MD FAMILY PRACTICE
  • Facility Address: 212 RUSSELL BLVD
    NACOGDOCHES, TX
    ZIP 75965
  • Facility Phone: 936 569-9238
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AARON C. POLK
  • NPI Number: 1578595997
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1016834
LAB Type Physician Office
Facility Name AARON C POLK JR MD FAMILY PRACTICE
Street 212 RUSSELL BLVD
City NACOGDOCHES
State TX
ZIP 75965
Phone 936 569-9238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Physician Office
Lab Director AARON C. POLK

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