45D1088159 CLIA NUMBER - AIR EVAC 68 AIR EVAC EMS, INC

Laboratory Demographics

  • CLIA Code: 45D1088159
  • Facility Name: AIR EVAC 68 AIR EVAC EMS, INC
  • Facility Address: 609 MEDICAL CENTER DRIVE SUITE 500 C/O WISE REGIONAL HEALTH SYSTEM
    DECATUR, TX
    ZIP 76234
  • Facility Phone: 940 627-2045
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MICHAEL COSENTINO
  • NPI Number: 1760560916
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 45D1088159
LAB Type Ambulance
Facility Name AIR EVAC 68 AIR EVAC EMS, INC
Street 609 MEDICAL CENTER DRIVE SUITE 500 C/O WISE REGIONAL HEALTH SYSTEM
City DECATUR
State TX
ZIP 76234
Phone 940 627-2045
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 MICHAEL COSENTINO

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