45D2293996 CLIA NUMBER - FREEDOM PRIMARY CARE PLLC

Laboratory Demographics

  • CLIA Code: 45D2293996
  • Facility Name: FREEDOM PRIMARY CARE PLLC
  • Facility Address: 12702 TOEPPERWEIN ROAD, SUITE 201
    LIVE OAK, TX
    ZIP 78233
  • Facility Phone: 706 799-7068
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LESLIE M. DUBOIS
  • NPI Number: 1750158002
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2293996
LAB Type Physician Office
Facility Name FREEDOM PRIMARY CARE PLLC
Street 12702 TOEPPERWEIN ROAD, SUITE 201
City LIVE OAK
State TX
ZIP 78233
Phone 706 799-7068
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Physician Office
Lab Director LESLIE M. DUBOIS

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