45D2140458 CLIA NUMBER - NACOGDOCHES FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 45D2140458

Facility Name: NACOGDOCHES FAMILY MEDICINE

Facility Address:
2702 N UNIVERSITY
NACOGDOCHES, TX
ZIP 75965
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Facility Phone Number: 936 221-5138

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1841881794

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	45D2140458
LAB Type	Physician Office
Facility Name	NACOGDOCHES FAMILY MEDICINE
Street	2702 N UNIVERSITY
City	NACOGDOCHES
State	TX
ZIP	75965
Phone	936 221-5138
CertificateType	4
CertificateEffectiveDate	11/21/2023
CertificateExpirationDate	11/20/2025
FacilityType	Waiver

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