45D2161302 CLIA NUMBER - CEDAR CREEK CLINIC

Laboratory Demographics

  • CLIA Code: 45D2161302
  • Facility Name: CEDAR CREEK CLINIC
  • Facility Address: 2418 W MAIN STREET
    GUN BARREL CITY, TX
    ZIP 75156
  • Facility Phone: 903 713-2000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN CALDWELL
  • NPI Number: 1134539000
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2161302
LAB Type Physician Office
Facility Name CEDAR CREEK CLINIC
Street 2418 W MAIN STREET
City GUN BARREL CITY
State TX
ZIP 75156
Phone 903 713-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Physician Office
Lab Director BENJAMIN CALDWELL

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