45D1017395 CLIA NUMBER - MOORE COUNTY ADULT MEDICINE

Laboratory Demographics

  • CLIA Code: 45D1017395
  • Facility Name: MOORE COUNTY ADULT MEDICINE
  • Facility Address: 224 SOUTH BLISS STREET
    DUMAS, TX
    ZIP 79029
  • Facility Phone: 806 934-7802
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GASIM H. BELLA
  • NPI Number: 1861685000
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1017395
LAB Type Physician Office
Facility Name MOORE COUNTY ADULT MEDICINE
Street 224 SOUTH BLISS STREET
City DUMAS
State TX
ZIP 79029
Phone 806 934-7802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Physician Office
Lab Director GASIM H. BELLA

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