45D2171062 CLIA NUMBER - BUFFALO FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D2171062
  • Facility Name: BUFFALO FAMILY PRACTICE
  • Facility Address: 1686 HWY 79 WEST
    BUFFALO, TX
    ZIP 75831
  • Facility Phone: 903 322-1290
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KEVIN S. JENSEN
  • NPI Number: 1548816721
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2171062
LAB Type Physician Office
Facility Name BUFFALO FAMILY PRACTICE
Street 1686 HWY 79 WEST
City BUFFALO
State TX
ZIP 75831
Phone 903 322-1290
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Physician Office
Lab Director KEVIN S. JENSEN

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