45D1028959 CLIA NUMBER - CARL A DAVIS, MD

Laboratory Demographics

  • CLIA Code: 45D1028959
  • Facility Name: CARL A DAVIS, MD
  • Facility Address: 613 RUSSELL BLVD
    NACOGDOCHES, TX
    ZIP 75965
  • Facility Phone: 936 305-4155
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARL A. DAVIS
  • NPI Number: 1376594044
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1028959
LAB Type Physician Office
Facility Name CARL A DAVIS, MD
Street 613 RUSSELL BLVD
City NACOGDOCHES
State TX
ZIP 75965
Phone 936 305-4155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Physician Office
Lab Director CARL A. DAVIS

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