45D2094034 CLIA NUMBER - SHANNON CLINIC - URGENT CARE WEST

Laboratory Demographics

  • CLIA Code: 45D2094034
  • Facility Name: SHANNON CLINIC - URGENT CARE WEST
  • Facility Address: 4251 SUNSET DR
    SAN ANGELO, TX
    ZIP 76904
  • Facility Phone: 325 658-1511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARK EDWARDS
  • NPI Number: 1790986719
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2094034
LAB Type Physician Office
Facility Name SHANNON CLINIC - URGENT CARE WEST
Street 4251 SUNSET DR
City SAN ANGELO
State TX
ZIP 76904
Phone 325 658-1511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Physician Office
Lab Director DR. MARK EDWARDS

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