45D1027127 CLIA NUMBER - NORTHEAST ORTHOPEDICS & SPORTS MEDICINE LLP

Laboratory Demographics

  • CLIA Code: 45D1027127
  • Facility Name: NORTHEAST ORTHOPEDICS & SPORTS MEDICINE LLP
  • Facility Address: 6704 RANDOLPH BLVD
    LIVE OAK, TX
    ZIP 78233
  • Facility Phone: (210) 477-5151
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID FOX
  • NPI Number: 1023356441
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D1027127
LAB Type Physician Office
Facility Name NORTHEAST ORTHOPEDICS & SPORTS MEDICINE LLP
Street 6704 RANDOLPH BLVD
City LIVE OAK
State TX
ZIP 78233
Phone 2104775151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director DAVID FOX

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This page was last updated on: 5/15/2026