45D1042874 CLIA NUMBER - MAXIM HEALTHCARE SERVICES INC

Laboratory Demographics

  • CLIA Code: 45D1042874
  • Facility Name: MAXIM HEALTHCARE SERVICES INC
  • Facility Address: 1828 ESE LOOP 323, SUITE 101
    TYLER, TX
    ZIP 75701
  • Facility Phone: 903 581-8881
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ROXANNA VAUGHN
  • NPI Number: 1871680256
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D1042874
LAB Type Home Health Agency
Facility Name MAXIM HEALTHCARE SERVICES INC
Street 1828 ESE LOOP 323, SUITE 101
City TYLER
State TX
ZIP 75701
Phone 903 581-8881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2023
Certificate Expiration Date 7/11/2025
Facility Type Home Health Agency
Lab Director ROXANNA VAUGHN

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This page was last updated on: 6/4/2025