45D0946025 CLIA NUMBER - WILLIAM A SHAVER MD PA

Laboratory Demographics

CLIA Number: 45D0946025

Facility Name: WILLIAM A SHAVER MD PA

Facility Address:
2405 BROADWAY
LUBBOCK, TX
ZIP 79401
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Facility Phone Number: 806 799-3644

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1598721938

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name Field Value
CLIA Number 45D0946025
LAB Type Physician Office
Facility Name WILLIAM A SHAVER MD PA
Street 2405 BROADWAY
City LUBBOCK
State TX
ZIP 79401
Phone 806 799-3644
CertificateType 4
CertificateEffectiveDate 5/15/2024
CertificateExpirationDate 5/14/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024