45D1064803 CLIA NUMBER - NACOGDOCHES CARDIAC CENTER, PA

Laboratory Demographics

  • CLIA Code: 45D1064803
  • Facility Name: NACOGDOCHES CARDIAC CENTER, PA
  • Facility Address: 1023 N MOUND ST STE K
    NACOGDOCHES, TX
    ZIP 75961
  • Facility Phone: 936 564-2099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAYA R. POKALA
  • NPI Number: 1487992889
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1064803
LAB Type Physician Office
Facility Name NACOGDOCHES CARDIAC CENTER, PA
Street 1023 N MOUND ST STE K
City NACOGDOCHES
State TX
ZIP 75961
Phone 936 564-2099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2025
Certificate Expiration Date 2/13/2027
Facility Type Physician Office
Lab Director VIJAYA R. POKALA

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