45D1106055 CLIA NUMBER - CONCHO VALLEY COUNCIL OF GOVERNMENTS HEAD START

Laboratory Demographics

CLIA Number: 45D1106055

Facility Name: CONCHO VALLEY COUNCIL OF GOVERNMENTS HEAD START

Facility Address:
5430 LINK RD
SAN ANGELO, TX
ZIP 76904
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Facility Phone Number: 325 944-9666

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1497155022

Taxonomy: 343800000X - Secured Medical Transport (VAN)
A public or privately owned transportation service with vehicles, specially equipped to provide enhanced safety, security and passenger restraint, and staffed by one or more individuals trained to work with patients in crisis situations resulting from mental or emotional illness and/or substance abuse.

CLIA Record

Field Name	Field Value
CLIA Number	45D1106055
LAB Type	School/Student Health Service
Facility Name	CONCHO VALLEY COUNCIL OF GOVERNMENTS HEAD START
Street	5430 LINK RD
City	SAN ANGELO
State	TX
ZIP	76904
Phone	325 944-9666
CertificateType	4
CertificateEffectiveDate	10/5/2023
CertificateExpirationDate	10/4/2025
FacilityType	Waiver

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