45D1050239 CLIA NUMBER - SHANNON CLINIC BAPTIST MEMORIAL CAMPUS

Laboratory Demographics

  • CLIA Code: 45D1050239
  • Facility Name: SHANNON CLINIC BAPTIST MEMORIAL CAMPUS
  • Facility Address: 903 NORTH MAIN
    SAN ANGELO, TX
    ZIP 76903
  • Facility Phone: 325 658-1511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: J CHRIS BARNETT
  • NPI Number: 1114119385
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D1050239
LAB Type Physician Office
Facility Name SHANNON CLINIC BAPTIST MEMORIAL CAMPUS
Street 903 NORTH MAIN
City SAN ANGELO
State TX
ZIP 76903
Phone 325 658-1511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Physician Office
Lab Director J CHRIS BARNETT

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