45D1061394 CLIA NUMBER - REGIONAL EMPLOYEE ASSISTANCE PROGRAM

Laboratory Demographics

  • CLIA Code: 45D1061394
  • Facility Name: REGIONAL EMPLOYEE ASSISTANCE PROGRAM
  • Facility Address: 1321 W HWY 22
    CORSICANA, TX
    ZIP 75110
  • Facility Phone: 903 602-8300
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: TIMOTHY R. MONTAIVO
  • NPI Number: 1831640747
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1061394
LAB Type Rural Health Clinic
Facility Name REGIONAL EMPLOYEE ASSISTANCE PROGRAM
Street 1321 W HWY 22
City CORSICANA
State TX
ZIP 75110
Phone 903 602-8300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2024
Certificate Expiration Date 11/27/2026
Facility Type Rural Health Clinic
Lab Director TIMOTHY R. MONTAIVO

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