45D1070155 CLIA NUMBER - SMITHSON VALLEY FAMILY MEDICINE LLP

Laboratory Demographics

  • CLIA Code: 45D1070155
  • Facility Name: SMITHSON VALLEY FAMILY MEDICINE LLP
  • Facility Address: 13201 FM 306
    CANYON LAKE, TX
    ZIP 78133
  • Facility Phone: (830) 885-5541
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW W. NICOLY
  • NPI Number: 1841322013
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1070155
LAB Type Physician Office
Facility Name SMITHSON VALLEY FAMILY MEDICINE LLP
Street 13201 FM 306
City CANYON LAKE
State TX
ZIP 78133
Phone 8308855541
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Physician Office
Lab Director MATTHEW W. NICOLY

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This page was last updated on: 6/29/2026