45D2076715 CLIA NUMBER - FIRST FAMILY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2076715
  • Facility Name: FIRST FAMILY CARE, PLLC
  • Facility Address: 208 E TX-114 SUITE 300
    ROANOKE, TX
    ZIP 76262
  • Facility Phone: 682 831-1591
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRAKASH BHAKTA
  • NPI Number: 1154666758
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2076715
LAB Type Physician Office
Facility Name FIRST FAMILY CARE, PLLC
Street 208 E TX-114 SUITE 300
City ROANOKE
State TX
ZIP 76262
Phone 682 831-1591
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Physician Office
Lab Director PRAKASH BHAKTA

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