45D2206368 CLIA NUMBER - BRIAN CARREON MD PA DBA SYCAMORE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 45D2206368
  • Facility Name: BRIAN CARREON MD PA DBA SYCAMORE FAMILY MEDICINE
  • Facility Address: 1502 12TH ST STE A
    SHALLOWATER, TX
    ZIP 79363
  • Facility Phone: 806 696-3700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN K. CARREON
  • NPI Number: 1831162221
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2206368
LAB Type Physician Office
Facility Name BRIAN CARREON MD PA DBA SYCAMORE FAMILY MEDICINE
Street 1502 12TH ST STE A
City SHALLOWATER
State TX
ZIP 79363
Phone 806 696-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Physician Office
Lab Director BRIAN K. CARREON

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