45D2207832 CLIA NUMBER - LONG CREEK ASSISTED LIVING & MEMORY CARE

Laboratory Demographics

  • CLIA Code: 45D2207832
  • Facility Name: LONG CREEK ASSISTED LIVING & MEMORY CARE
  • Facility Address: 301 TC LUPTON BLVD
    SUNNYVALE, TX
    ZIP 75182
  • Facility Phone: 469 563-7899
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: CLINTON PONCY
  • NPI Number: 1407389075
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2207832
LAB Type Ancillary Testing Site in Health Care Center
Facility Name LONG CREEK ASSISTED LIVING & MEMORY CARE
Street 301 TC LUPTON BLVD
City SUNNYVALE
State TX
ZIP 75182
Phone 469 563-7899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director CLINTON PONCY

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