45D2079945 CLIA NUMBER - STINNETT MEDICAL CLINIC

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Laboratory Demographics

CLIA Number: 45D2079945

Facility Name: STINNETT MEDICAL CLINIC

Facility Address:
711 SOUTH STEWART
STINNETT, TX
ZIP 79083
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Facility Phone Number: 806 878-2271

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1619498896

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2079945
LAB Type	Community Clinic
Facility Name	STINNETT MEDICAL CLINIC
Street	711 SOUTH STEWART
City	STINNETT
State	TX
ZIP	79083
Phone	806 878-2271
CertificateType	4
CertificateEffectiveDate	7/29/2022
CertificateExpirationDate	7/28/2024
FacilityType	Waiver

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