45D0912758 CLIA NUMBER - JACKSON MEDICAL CLINIC OF EDNA

Laboratory Demographics

  • CLIA Code: 45D0912758
  • Facility Name: JACKSON MEDICAL CLINIC OF EDNA
  • Facility Address: 1013 A SOUTH WELLS
    EDNA, TX
    ZIP 77957
  • Facility Phone: (512) 782-5241
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: ORLANDO BARONA
  • NPI Number: 1346283033
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0912758
LAB Type Other
Facility Name JACKSON MEDICAL CLINIC OF EDNA
Street 1013 A SOUTH WELLS
City EDNA
State TX
ZIP 77957
Phone 5127825241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2026
Certificate Expiration Date 5/11/2028
Facility Type Other
Lab Director ORLANDO BARONA

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This page was last updated on: 5/18/2026