45D2153699 CLIA NUMBER - PECOS STREET PHARMACY, INC MEDICAL ARTS PHARMACY

Laboratory Demographics

  • CLIA Code: 45D2153699
  • Facility Name: PECOS STREET PHARMACY, INC MEDICAL ARTS PHARMACY
  • Facility Address: 2102 PECOS ST
    SAN ANGELO, TX
    ZIP 76901
  • Facility Phone: 325 949-4636
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRYAN T. ABERNATHY
  • NPI Number: 1659374379
  • Taxonomy: 3336L0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2153699
LAB Type Physician Office
Facility Name PECOS STREET PHARMACY, INC MEDICAL ARTS PHARMACY
Street 2102 PECOS ST
City SAN ANGELO
State TX
ZIP 76901
Phone 325 949-4636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Physician Office
Lab Director BRYAN T. ABERNATHY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025