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PHYNET, INC
NPI 1023275096
Clinic/Center - Health Service in Jefferson, TX

Active since May 19, 2008CLIA 45D1079447 · Waiver
219 N POLK ST, JEFFERSON, TX 75657(903) 665-2600(903) 665-2608 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Phynet, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYNET, INC (NPI 1023275096), doing business as Jefferson Life Center, is a healthcare organization registered as a health service in Jefferson, Texas and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through December 21, 2027 and lists John D. Ford, President, as its authorized official.

NPPES Registry Identity

NPI1023275096
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NamePHYNET, INC
Location Address219 N POLK STJefferson, TX 75657-2131
Mailing Address4002 Technology CtrLongview, TX 75605-2697 · (903) 247-0484 · Fax (903) 247-0485
Phone(903) 665-2600
Fax(903) 665-2608
Organization SubpartYesParent: Phynet Inc
Authorized OfficialJohn D. FordPresident · (903) 247-0484
Enumeration DateMay 19, 2008
Last NPPES UpdateMarch 19, 2025
NPPES CertifiedMarch 19, 2025
✔ NPI 1023275096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
219 N POLK ST, Jefferson, TX 75657
Open in Google Maps ↗

Other Names 1

Doing Business AsJefferson Life Center

Other Identifiers 1

Medicaid159694201TX

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1079447

Phynet, Inc · Jefferson, TX
Active · expires Dec 21, 2027
CLIA Number45D1079447
Laboratory TypePhysician Office
Certificate Effective DateDecember 22, 2025
Certificate Expiration DateDecember 21, 2027
Laboratory DirectorDarrell Bunch
Laboratory Phone(903) 665-2600
Laboratory LocationPhynet, Inc219 N Polk St, Jefferson, TX 75657
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHYNET, INC
Clinic/Center (Rural Health)
219 N POLK ST
JEFFERSON, TX 75657
Marion County (903) 247-0484
ROBIN LYNNE GALE PNP
Nurse Practitioner (Pediatrics)
219 N POLK ST
JEFFERSON, TX 75657
Marion County (903) 665-2600
MARSHALL PHYSICAL THERAPY, INC
Physical Medicine & Rehabilitation
219 N POLK ST
JEFFERSON, TX 75657
Marion County (903) 665-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phynet, Inc's NPI number?

The NPI number for Phynet, Inc is 1023275096. It was assigned to this organization in the NPPES registry on May 19, 2008. The provider is doing business as Jefferson Life Center.

Where is Phynet, Inc located?

Phynet, Inc is located at 219 N Polk St, Jefferson, TX 75657. The listed phone number is (903) 665-2600.

What is Phynet, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Phynet, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1079447) is associated with this NPI, valid through December 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Phynet, Inc was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.