45D2080185 CLIA NUMBER - AGAPE INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 45D2080185
  • Facility Name: AGAPE INTERNAL MEDICINE, PC
  • Facility Address: 217 N RIDGEWAY DR SUITE 200
    CLEBURNE, TX
    ZIP 76033
  • Facility Phone: 817 556-0201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN B. DARAMOLA
  • NPI Number: 1376896845
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D2080185
LAB Type Physician Office
Facility Name AGAPE INTERNAL MEDICINE, PC
Street 217 N RIDGEWAY DR SUITE 200
City CLEBURNE
State TX
ZIP 76033
Phone 817 556-0201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director JOHN B. DARAMOLA

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