45D1088158 CLIA NUMBER - AIR EVAC 69 AIR EVAC EMS INC

Laboratory Demographics

  • CLIA Code: 45D1088158
  • Facility Name: AIR EVAC 69 AIR EVAC EMS INC
  • Facility Address: 1308 PALUXY ROAD SUITE C
    GRANBURY, TX
    ZIP 76048
  • Facility Phone: 417 274-8722
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MARTHA HEADRICK
  • NPI Number: 1285712414
  • Taxonomy: 3416A0800X - Ambulance

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1088158
LAB Type Ambulance
Facility Name AIR EVAC 69 AIR EVAC EMS INC
Street 1308 PALUXY ROAD SUITE C
City GRANBURY
State TX
ZIP 76048
Phone 417 274-8722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Ambulance
Lab Director MARTHA HEADRICK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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