45D2111804 CLIA NUMBER - HOMETOWN CLINIC, LLC

Laboratory Demographics

CLIA Number: 45D2111804

Facility Name: HOMETOWN CLINIC, LLC

Facility Address:
2725 NE LOOP 286
PARIS, TX
ZIP 75460
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Facility Phone Number: 903 905-4810

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1285010496

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2111804
LAB Type	Practitioner Other
Facility Name	HOMETOWN CLINIC, LLC
Street	2725 NE LOOP 286
City	PARIS
State	TX
ZIP	75460
Phone	903 905-4810
CertificateType	4
CertificateEffectiveDate	4/15/2024
CertificateExpirationDate	4/14/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024