45D2249579 CLIA NUMBER - CAREATC - VISTRA COMANCHE PEAK

Laboratory Demographics

  • CLIA Code: 45D2249579
  • Facility Name: CAREATC - VISTRA COMANCHE PEAK
  • Facility Address: 6322 N. FM 56
    GLEN ROSE, TX
    ZIP 76043
  • Facility Phone: 918 779-7471
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AUSTIN DAVIDSON
  • NPI Number: 1447069398
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2249579
LAB Type Physician Office
Facility Name CAREATC - VISTRA COMANCHE PEAK
Street 6322 N. FM 56
City GLEN ROSE
State TX
ZIP 76043
Phone 918 779-7471
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 Physician Office
Lab Director AUSTIN DAVIDSON

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