45D2119202 CLIA NUMBER - CCMH FAMILY CLINIC- MEDICAL OFFICE BLDG 2

Laboratory Demographics

  • CLIA Code: 45D2119202
  • Facility Name: CCMH FAMILY CLINIC- MEDICAL OFFICE BLDG 2
  • Facility Address: 102 SOUTH ARCHER STREET
    HENRIETTA, TX
    ZIP 76365
  • Facility Phone: 940 538-0454
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN N. GUERRERO
  • NPI Number: 1013357953
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2119202
LAB Type Physician Office
Facility Name CCMH FAMILY CLINIC- MEDICAL OFFICE BLDG 2
Street 102 SOUTH ARCHER STREET
City HENRIETTA
State TX
ZIP 76365
Phone 940 538-0454
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Physician Office
Lab Director CHRISTIAN N. GUERRERO

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