45D2010896 CLIA NUMBER - TERRI ANNE RUSSELL MD

Laboratory Demographics

  • CLIA Code: 45D2010896
  • Facility Name: TERRI ANNE RUSSELL MD
  • Facility Address: 1105 S MEDINA
    LOCKHART, TX
    ZIP 78644
  • Facility Phone: 512 467-7111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRI ANNE RUSSELL
  • NPI Number: 1760652770
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D2010896
LAB Type Physician Office
Facility Name TERRI ANNE RUSSELL MD
Street 1105 S MEDINA
City LOCKHART
State TX
ZIP 78644
Phone 512 467-7111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Physician Office
Lab Director TERRI ANNE RUSSELL

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