45D2004754 CLIA NUMBER - MARFA COUNTRY CLINIC

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Laboratory Demographics

CLIA Number: 45D2004754

Facility Name: MARFA COUNTRY CLINIC

Facility Address:
105 EAST OAK STREET
MARFA, TX
ZIP 79843
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Facility Phone Number: 432 935-4285

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528380854

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2004754
LAB Type	Physician Office
Facility Name	MARFA COUNTRY CLINIC
Street	105 EAST OAK STREET
City	MARFA
State	TX
ZIP	79843
Phone	432 935-4285
CertificateType	4
CertificateEffectiveDate	3/11/2024
CertificateExpirationDate	3/10/2026
FacilityType	Waiver

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