45D2298147 CLIA NUMBER - SOUTHERN ROOTS FAMILY CARE

Laboratory Demographics

  • CLIA Code: 45D2298147
  • Facility Name: SOUTHERN ROOTS FAMILY CARE
  • Facility Address: 400 W CALVERT ST, UNIT C
    TROUP, TX
    ZIP 75789
  • Facility Phone: (903) 969-5056
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHANIE M. MCCLURE
  • NPI Number: 1891487070
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2298147
LAB Type Physician Office
Facility Name SOUTHERN ROOTS FAMILY CARE
Street 400 W CALVERT ST, UNIT C
City TROUP
State TX
ZIP 75789
Phone 9039695056
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2026
Certificate Expiration Date 1/29/2028
Facility Type Physician Office
Lab Director STEPHANIE M. MCCLURE

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This page was last updated on: 5/15/2026