45D1091354 CLIA NUMBER - ETMC PHYSICIAN GROUP, INC

Laboratory Demographics

  • CLIA Code: 45D1091354
  • Facility Name: ETMC PHYSICIAN GROUP, INC
  • Facility Address: 14069 FM 849
    LINDALE, TX
    ZIP 75771
  • Facility Phone: 903 590-5260
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROGER PEARCE
  • NPI Number: 1598332868
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1091354
LAB Type Physician Office
Facility Name ETMC PHYSICIAN GROUP, INC
Street 14069 FM 849
City LINDALE
State TX
ZIP 75771
Phone 903 590-5260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Physician Office
Lab Director ROGER PEARCE

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