45D1043715 CLIA NUMBER - RUSSELL DOUBRAVA, DO

Laboratory Demographics

  • CLIA Code: 45D1043715
  • Facility Name: RUSSELL DOUBRAVA, DO
  • Facility Address: 2451 S FM 51, SUITE 100
    DECATUR, TX
    ZIP 76234
  • Facility Phone: 940 627-0088
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RUSSELL G. DOUBRAVA
  • NPI Number: 1639135452
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 45D1043715
LAB Type Physician Office
Facility Name RUSSELL DOUBRAVA, DO
Street 2451 S FM 51, SUITE 100
City DECATUR
State TX
ZIP 76234
Phone 940 627-0088
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Physician Office
Lab Director RUSSELL G. DOUBRAVA

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