45D2247584 CLIA NUMBER - BUTLER FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2247584
  • Facility Name: BUTLER FAMILY PRACTICE, PLLC
  • Facility Address: 6713 OLD JACKSONVILLE HWY, SUITE 204
    TYLER, TX
    ZIP 75703
  • Facility Phone: 903 630-2197
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BEVERLY D. BUTLER
  • NPI Number: 1447807136
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2247584
LAB Type Practitioner Other
Facility Name BUTLER FAMILY PRACTICE, PLLC
Street 6713 OLD JACKSONVILLE HWY, SUITE 204
City TYLER
State TX
ZIP 75703
Phone 903 630-2197
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Practitioner Other
Lab Director BEVERLY D. BUTLER

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