45D2163329 CLIA NUMBER - MATAGORDA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D2163329
  • Facility Name: MATAGORDA FAMILY PRACTICE
  • Facility Address: 320 MAIN ST
    PALACIOS, TX
    ZIP 77465
  • Facility Phone: 361 972-0095
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE BARKER
  • NPI Number: 1467009092
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2163329
LAB Type Physician Office
Facility Name MATAGORDA FAMILY PRACTICE
Street 320 MAIN ST
City PALACIOS
State TX
ZIP 77465
Phone 361 972-0095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Physician Office
Lab Director BRUCE BARKER

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