45D1036359 CLIA NUMBER - PERMIAN INTERNAL MEDICINE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 45D1036359
  • Facility Name: PERMIAN INTERNAL MEDICINE ASSOCIATES
  • Facility Address: 403 PITTSBURG AVENUE
    ODESSA, TX
    ZIP 79761
  • Facility Phone: 432 332-3400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SURESH PRASAD
  • NPI Number: 1114012283
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1036359
LAB Type Physician Office
Facility Name PERMIAN INTERNAL MEDICINE ASSOCIATES
Street 403 PITTSBURG AVENUE
City ODESSA
State TX
ZIP 79761
Phone 432 332-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Physician Office
Lab Director SURESH PRASAD

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