45D2270418 CLIA NUMBER - JACKSBORO ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 45D2270418
  • Facility Name: JACKSBORO ASSISTED LIVING
  • Facility Address: 1116 US SH 148
    JACKSBORO, TX
    ZIP 76458
  • Facility Phone: 940 567-3057
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BECKY TAFF
  • NPI Number: 1164640363
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2270418
LAB Type Assisted Living Facility
Facility Name JACKSBORO ASSISTED LIVING
Street 1116 US SH 148
City JACKSBORO
State TX
ZIP 76458
Phone 940 567-3057
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Assisted Living Facility
Lab Director BECKY TAFF

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