45D2219673 CLIA NUMBER - DECATUR VA CLINIC

Laboratory Demographics

  • CLIA Code: 45D2219673
  • Facility Name: DECATUR VA CLINIC
  • Facility Address: 408 PARK WEST COURT
    DECATUR, TX
    ZIP 76234
  • Facility Phone: 469 634-1800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER ELLIS
  • NPI Number: 1568417087
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2219673
LAB Type Physician Office
Facility Name DECATUR VA CLINIC
Street 408 PARK WEST COURT
City DECATUR
State TX
ZIP 76234
Phone 469 634-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director CHRISTOPHER ELLIS

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