45D1092774 CLIA NUMBER - LONE STAR PAIN MEDICINE

Laboratory Demographics

  • CLIA Code: 45D1092774
  • Facility Name: LONE STAR PAIN MEDICINE
  • Facility Address: 907 E EUREKA ST SUITE B
    WEATHERFORD, TX
    ZIP 76086
  • Facility Phone: 817 599-4901
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. CARISSA CHAMPANG
  • NPI Number: 1356861157
  • Taxonomy: 246ZC0007X - Specialist/Technologist, Other

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CLIA Record

Field Name Field Value
CLIA Number 45D1092774
LAB Type Physician Office
Facility Name LONE STAR PAIN MEDICINE
Street 907 E EUREKA ST SUITE B
City WEATHERFORD
State TX
ZIP 76086
Phone 817 599-4901
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 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Physician Office
Lab Director DR. CARISSA CHAMPANG

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