45D2264154 CLIA NUMBER - ELITE FAMILY PRACTICE,LLC

Laboratory Demographics

  • CLIA Code: 45D2264154
  • Facility Name: ELITE FAMILY PRACTICE,LLC
  • Facility Address: 1900 W WALL STREET, SUITE B
    MIDLAND, TX
    ZIP 79701
  • Facility Phone: 432 247-1309
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RICKY HAMBY
  • NPI Number: 1629708151
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2264154
LAB Type Practitioner Other
Facility Name ELITE FAMILY PRACTICE,LLC
Street 1900 W WALL STREET, SUITE B
City MIDLAND
State TX
ZIP 79701
Phone 432 247-1309
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Practitioner Other
Lab Director RICKY HAMBY

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: 9/29/2025