45D2176138 CLIA NUMBER - SHAW PAIN CLINIC PLLC

Laboratory Demographics

  • CLIA Code: 45D2176138
  • Facility Name: SHAW PAIN CLINIC PLLC
  • Facility Address: 1005 FALLS PKWY #105
    MARBLE FALLS, TX
    ZIP 78654
  • Facility Phone: 830 220-5007
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEROD K. SHAW
  • NPI Number: 1104479146
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2176138
LAB Type Physician Office
Facility Name SHAW PAIN CLINIC PLLC
Street 1005 FALLS PKWY #105
City MARBLE FALLS
State TX
ZIP 78654
Phone 830 220-5007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director JEROD K. SHAW

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