45D1067025 CLIA NUMBER - MANSFIELD MEDICAL LODGE

Laboratory Demographics

  • CLIA Code: 45D1067025
  • Facility Name: MANSFIELD MEDICAL LODGE
  • Facility Address: 301 N MILLER ROAD
    MANSFIELD, TX
    ZIP 76063
  • Facility Phone: 817 276-4800
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DAVID J. SMEJKAL
  • NPI Number: 1386047645
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1067025
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MANSFIELD MEDICAL LODGE
Street 301 N MILLER ROAD
City MANSFIELD
State TX
ZIP 76063
Phone 817 276-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DAVID J. SMEJKAL

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