45D2137437 CLIA NUMBER - C- PORT LLC SERIES B-HOSPICE

Laboratory Demographics

  • CLIA Code: 45D2137437
  • Facility Name: C- PORT LLC SERIES B-HOSPICE
  • Facility Address: 315 S MAIN ST SUITE 100
    MANSFIELD, TX
    ZIP 76063
  • Facility Phone: 469 630-2538
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DAVID M. DOWD
  • NPI Number: 1578090957
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2137437
LAB Type Hospice
Facility Name C- PORT LLC SERIES B-HOSPICE
Street 315 S MAIN ST SUITE 100
City MANSFIELD
State TX
ZIP 76063
Phone 469 630-2538
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2025
Certificate Expiration Date 9/25/2027
Facility Type Hospice
Lab Director DAVID M. DOWD

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