45D1028534 CLIA NUMBER - HOMETOWN HEALTHCARE LLC

Laboratory Demographics

CLIA Number: 45D1028534

Facility Name: HOMETOWN HEALTHCARE LLC

Facility Address:
404 E SAN MARCOS ST
PEARSALL, TX
ZIP 78061
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Facility Phone Number: 830 334-3336

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184941346

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D1028534
LAB Type	Physician Office
Facility Name	HOMETOWN HEALTHCARE LLC
Street	404 E SAN MARCOS ST
City	PEARSALL
State	TX
ZIP	78061
Phone	830 334-3336
CertificateType	4
CertificateEffectiveDate	7/27/2022
CertificateExpirationDate	7/26/2024
FacilityType	Waiver

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