45D1019934 CLIA NUMBER - COGDELL CLINIC

Laboratory Demographics

  • CLIA Code: 45D1019934
  • Facility Name: COGDELL CLINIC
  • Facility Address: 320 N MAIN STREET
    LOCKNEY, TX
    ZIP 79241
  • Facility Phone: 806 652-3373
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: GARY B. MANGOLD MD
  • NPI Number: 1508169509
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1019934
LAB Type Rural Health Clinic
Facility Name COGDELL CLINIC
Street 320 N MAIN STREET
City LOCKNEY
State TX
ZIP 79241
Phone 806 652-3373
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Rural Health Clinic
Lab Director GARY B. MANGOLD MD

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