45D1088444 CLIA NUMBER - PREMISE HEALTH OF TEXAS MEDICAL, PA

Laboratory Demographics

  • CLIA Code: 45D1088444
  • Facility Name: PREMISE HEALTH OF TEXAS MEDICAL, PA
  • Facility Address: 2330 W 10TH STREET
    ODESSA, TX
    ZIP 79763
  • Facility Phone: 432 375-6020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA DARLING
  • NPI Number: 1750345088
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1088444
LAB Type Physician Office
Facility Name PREMISE HEALTH OF TEXAS MEDICAL, PA
Street 2330 W 10TH STREET
City ODESSA
State TX
ZIP 79763
Phone 432 375-6020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Physician Office
Lab Director AMANDA DARLING

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