45D2141972 CLIA NUMBER - AIR EVAC LIFETEAM 147/MAC 2

Laboratory Demographics

  • CLIA Code: 45D2141972
  • Facility Name: AIR EVAC LIFETEAM 147/MAC 2
  • Facility Address: 159 MEDICAL DRIVE
    PEARSALL, TX
    ZIP 78061
  • Facility Phone: 830 309-2980
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MICHAEL KEATON
  • NPI Number: 1427579960
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 45D2141972
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM 147/MAC 2
Street 159 MEDICAL DRIVE
City PEARSALL
State TX
ZIP 78061
Phone 830 309-2980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Mobile Laboratory
Lab Director MICHAEL KEATON

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