45D1044009 CLIA NUMBER - DEKALB PHYSICIANS CLINIC

Laboratory Demographics

  • CLIA Code: 45D1044009
  • Facility Name: DEKALB PHYSICIANS CLINIC
  • Facility Address: 216 CENTRE ST
    DE KALB, TX
    ZIP 75559
  • Facility Phone: (903) 667-2273
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KYLE W. GROOM
  • NPI Number: 1265565691
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1044009
LAB Type Physician Office
Facility Name DEKALB PHYSICIANS CLINIC
Street 216 CENTRE ST
City DE KALB
State TX
ZIP 75559
Phone 9036672273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director KYLE W. GROOM

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This page was last updated on: 5/18/2026