45D2324720 CLIA NUMBER - CENTER CARE CLINIC PLLC

Laboratory Demographics

  • CLIA Code: 45D2324720
  • Facility Name: CENTER CARE CLINIC PLLC
  • Facility Address: 1738 SOUTH JACKSON STREET
    JACKSONVILLE, TX
    ZIP 75766
  • Facility Phone: 903 284-6327
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHAQUARRA L. MITCHELL
  • NPI Number: 1972391886
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2324720
LAB Type Practitioner Other
Facility Name CENTER CARE CLINIC PLLC
Street 1738 SOUTH JACKSON STREET
City JACKSONVILLE
State TX
ZIP 75766
Phone 903 284-6327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Practitioner Other
Lab Director CHAQUARRA L. MITCHELL

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