45D2006136 CLIA NUMBER - WILBARGER GENERAL MEDICAL GROUP

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Laboratory Demographics

CLIA Number: 45D2006136

Facility Name: WILBARGER GENERAL MEDICAL GROUP

Facility Address:
4301 COLLEGE DRIVE SUITE 800
VERNON, TX
ZIP 76384
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Facility Phone Number: 940 553-2965

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578688834

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2006136
LAB Type	Physician Office
Facility Name	WILBARGER GENERAL MEDICAL GROUP
Street	4301 COLLEGE DRIVE SUITE 800
City	VERNON
State	TX
ZIP	76384
Phone	940 553-2965
CertificateType	4
CertificateEffectiveDate	4/13/2024
CertificateExpirationDate	4/12/2026
FacilityType	Waiver

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