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LIBERTY DAYTON MEDICAL SPECIALTY CLINIC
NPI 1386401560
Clinic/Center - Rural Health in Liberty, TX

Active since March 04, 2024CLIA 45D2088676 · Waiver
1202 N TRAVIS ST, LIBERTY, TX 77575(281) 915-0749 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Liberty Dayton Medical Specialty Clinic NPPES

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

LIBERTY DAYTON MEDICAL SPECIALTY CLINIC (NPI 1386401560) is a healthcare organization registered as a rural health in Liberty, Texas and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through December 15, 2026 and lists Rhonda Campbell, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1386401560
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLIBERTY COUNTY HOSPITAL DISTRICT NO 1
Location Address1202 N TRAVIS STLiberty, TX 77575-3540
Mailing Address1353 N Travis StLiberty, TX 77575-3549 · (936) 336-7316
Phone(281) 915-0749
Organization SubpartNo
Authorized OfficialRhonda CampbellChief Executive Officer · (936) 336-7316
Enumeration DateMarch 4, 2024
Last NPPES UpdateMarch 6, 2024
NPPES CertifiedMarch 6, 2024
✔ NPI 1386401560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1202 N TRAVIS ST, Liberty, TX 77575
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Other Names 1

Doing Business AsLiberty Dayton Medical Specialty Clinic

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 45D2088676

Liberty Dayton Medical Clinic · Liberty, TX
Active · expires Dec 15, 2026
CLIA Number45D2088676
Laboratory TypeRural Health Clinic
Certificate Effective DateDecember 16, 2024
Certificate Expiration DateDecember 15, 2026
Laboratory DirectorAmanual M. Abreha
Laboratory Phone(936) 336-7316
Laboratory LocationLiberty Dayton Medical Clinic1201 N Travis, Liberty, TX 77575
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is LIBERTY COUNTY HOSPITAL DISTRICT NO 1's NPI number?

The NPI number assigned to this healthcare provider is 1386401560, enumerated as an "organization" on March 04, 2024.

Where is the provider located?

The provider is located at 1202 N TRAVIS ST LIBERTY, TX 77575 and the phone number is (281) 915-0749.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.