45D2113380 CLIA NUMBER - WELLMED AT BONHAM

Laboratory Demographics

  • CLIA Code: 45D2113380
  • Facility Name: WELLMED AT BONHAM
  • Facility Address: 201 W 5TH STREET
    BONHAM, TX
    ZIP 75418
  • Facility Phone: 903 640-4700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENARJI TEGALA
  • NPI Number: 1518925841
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2113380
LAB Type Physician Office
Facility Name WELLMED AT BONHAM
Street 201 W 5TH STREET
City BONHAM
State TX
ZIP 75418
Phone 903 640-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Physician Office
Lab Director BENARJI TEGALA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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