45D1072466 CLIA NUMBER - TYLER VA PRIMARY CARE CLINIC

Laboratory Demographics

  • CLIA Code: 45D1072466
  • Facility Name: TYLER VA PRIMARY CARE CLINIC
  • Facility Address: 7916 S BROADWAY AVENUE
    TYLER, TX
    ZIP 75703
  • Facility Phone: 903 593-6064
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: SHELBY MELTON
  • NPI Number: 1629459730
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1072466
LAB Type Community Clinic
Facility Name TYLER VA PRIMARY CARE CLINIC
Street 7916 S BROADWAY AVENUE
City TYLER
State TX
ZIP 75703
Phone 903 593-6064
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 8/17/2007
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director SHELBY MELTON

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