45D1050088 CLIA NUMBER - DAFTARIAN FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D1050088
  • Facility Name: DAFTARIAN FAMILY PRACTICE
  • Facility Address: 2710 OSLER BLVD
    BRYAN, TX
    ZIP 77802
  • Facility Phone: 979 776-2277
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AREZU DAFTARIAN
  • NPI Number: 1841246220
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1050088
LAB Type Physician Office
Facility Name DAFTARIAN FAMILY PRACTICE
Street 2710 OSLER BLVD
City BRYAN
State TX
ZIP 77802
Phone 979 776-2277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Physician Office
Lab Director AREZU DAFTARIAN

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