45D2017994 CLIA NUMBER - HOMETOWN HEALTHCARE LLC

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Laboratory Demographics

CLIA Number: 45D2017994

Facility Name: HOMETOWN HEALTHCARE LLC

Facility Address:
408 N GIRAUD
COTULLA, TX
ZIP 78014
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Facility Phone Number: 830 879-2279

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1881911030

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2017994
LAB Type	Rural Health Clinic
Facility Name	HOMETOWN HEALTHCARE LLC
Street	408 N GIRAUD
City	COTULLA
State	TX
ZIP	78014
Phone	830 879-2279
CertificateType	4
CertificateEffectiveDate	12/22/2022
CertificateExpirationDate	12/21/2024
FacilityType	Waiver

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