45D2064352 CLIA NUMBER - MADISON MEDICAL RESORT

Laboratory Demographics

  • CLIA Code: 45D2064352
  • Facility Name: MADISON MEDICAL RESORT
  • Facility Address: 5001 OFFICE PARK DRIVE
    ODESSA, TX
    ZIP 79762
  • Facility Phone: 432 362-1800
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TRAVIS GREEN
  • NPI Number: 1104269448
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2064352
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MADISON MEDICAL RESORT
Street 5001 OFFICE PARK DRIVE
City ODESSA
State TX
ZIP 79762
Phone 432 362-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TRAVIS GREEN

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