45D2211861 CLIA NUMBER - ADJUVA PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 45D2211861
  • Facility Name: ADJUVA PRIMARY CARE
  • Facility Address: 4901 STATE HWY 114 SUITE 102
    NORTHLAKE, TX
    ZIP 76262
  • Facility Phone: 817 554-2121
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MARGARET A. STINNETT
  • NPI Number: 1316553043
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2211861
LAB Type Practitioner Other
Facility Name ADJUVA PRIMARY CARE
Street 4901 STATE HWY 114 SUITE 102
City NORTHLAKE
State TX
ZIP 76262
Phone 817 554-2121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Practitioner Other
Lab Director MARGARET A. STINNETT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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