45D2111455 CLIA NUMBER - RACHEL B HEAD, MD

Laboratory Demographics

  • CLIA Code: 45D2111455
  • Facility Name: RACHEL B HEAD, MD
  • Facility Address: 617 RUSSELL BLVD
    NACOGDOCHES, TX
    ZIP 75965
  • Facility Phone: 936 305-5109
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RACHEL B. HEAD
  • NPI Number: 1407084114
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 45D2111455
LAB Type Physician Office
Facility Name RACHEL B HEAD, MD
Street 617 RUSSELL BLVD
City NACOGDOCHES
State TX
ZIP 75965
Phone 936 305-5109
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director RACHEL B. HEAD

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