45D1020474 CLIA NUMBER - SOUTHEAST TYLER DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D1020474
  • Facility Name: SOUTHEAST TYLER DIALYSIS
  • Facility Address: 3826 TROUP HIGHWAY SUITE L
    TYLER, TX
    ZIP 75701
  • Facility Phone: 903 531-9498
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MARTHA A. COLFER
  • NPI Number: 1801998224
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1020474
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTHEAST TYLER DIALYSIS
Street 3826 TROUP HIGHWAY SUITE L
City TYLER
State TX
ZIP 75701
Phone 903 531-9498
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MARTHA A. COLFER

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