45D2177839 CLIA NUMBER - TEXOMA COMMUNITY CENTER

Laboratory Demographics

  • CLIA Code: 45D2177839
  • Facility Name: TEXOMA COMMUNITY CENTER
  • Facility Address: 1221 EAST 6TH STREET
    BONHAM, TX
    ZIP 75418
  • Facility Phone: 903 957-4869
  • Facility Type: Other - COMMUNITY HEALTH CTR
  • Facility Type: Waiver
  • Lab Director: BRENT R. PHILLIPS-BROADRICK
  • NPI Number: 1386845915
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 45D2177839
LAB Type Other - COMMUNITY HEALTH CTR
Facility Name TEXOMA COMMUNITY CENTER
Street 1221 EAST 6TH STREET
City BONHAM
State TX
ZIP 75418
Phone 903 957-4869
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Other - COMMUNITY HEALTH CTR
Lab Director BRENT R. PHILLIPS-BROADRICK

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