45D1011964 CLIA NUMBER - ODESSA ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 45D1011964
  • Facility Name: ODESSA ENDOSCOPY CENTER LLC
  • Facility Address: 315 EAST 5TH STREET
    ODESSA, TX
    ZIP 79761
  • Facility Phone: 432 335-8300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PRATYUSHA PARAVA
  • NPI Number: 1629386784
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1011964
LAB Type Ambulatory Surgery Center
Facility Name ODESSA ENDOSCOPY CENTER LLC
Street 315 EAST 5TH STREET
City ODESSA
State TX
ZIP 79761
Phone 432 335-8300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Ambulatory Surgery Center
Lab Director PRATYUSHA PARAVA

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This page was last updated on: 9/29/2025