45D1068987 CLIA NUMBER - DANIEL R THEESFELD MD

Laboratory Demographics

  • CLIA Code: 45D1068987
  • Facility Name: DANIEL R THEESFELD MD
  • Facility Address: 3217 N 4TH ST
    LONGVIEW, TX
    ZIP 75605
  • Facility Phone: 936 560-2222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL R. THEESFELD, MD
  • NPI Number: 1891233987
  • Taxonomy: 133V00000X - Dietitian, Registered

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CLIA Record

Field Name Field Value
CLIA Number 45D1068987
LAB Type Physician Office
Facility Name DANIEL R THEESFELD MD
Street 3217 N 4TH ST
City LONGVIEW
State TX
ZIP 75605
Phone 936 560-2222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Physician Office
Lab Director DANIEL R. THEESFELD, MD

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