45D1072570 CLIA NUMBER - ETMC PHYSICIAN GROUP, INC

Laboratory Demographics

  • CLIA Code: 45D1072570
  • Facility Name: ETMC PHYSICIAN GROUP, INC
  • Facility Address: 18118 FM 344W
    FLINT, TX
    ZIP 75762
  • Facility Phone: 903 825-3292
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN P. RYDZAK
  • NPI Number: 1093382368
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1072570
LAB Type Physician Office
Facility Name ETMC PHYSICIAN GROUP, INC
Street 18118 FM 344W
City FLINT
State TX
ZIP 75762
Phone 903 825-3292
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director STEPHEN P. RYDZAK

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