45D1088444 CLIA NUMBER - ECTOR COUNTY EMPLOYEE WELLNESS CENTER

Laboratory Demographics

CLIA Number: 45D1088444

Facility Name: ECTOR COUNTY EMPLOYEE WELLNESS CENTER

Facility Address:
2330 W 10TH STREET
ODESSA, TX
ZIP 79763
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Facility Phone Number: 432 375-6020

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1750345088

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D1088444
LAB Type	Physician Office
Facility Name	ECTOR COUNTY EMPLOYEE WELLNESS CENTER
Street	2330 W 10TH STREET
City	ODESSA
State	TX
ZIP	79763
Phone	432 375-6020
CertificateType	4
CertificateEffectiveDate	1/21/2024
CertificateExpirationDate	1/20/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024