45D2280300 CLIA NUMBER - THE PRAIRIE RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 45D2280300
  • Facility Name: THE PRAIRIE RECOVERY CENTER
  • Facility Address: 5808 WAGNER RD
    ROUND TOP, TX
    ZIP 78954
  • Facility Phone: 979 530-6161
  • Facility Type: Other - INPATIENT SUBSTANCE AND A
  • Facility Type: Waiver
  • Lab Director: CARLOS TIRADO
  • NPI Number: 1598306862
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2280300
LAB Type Other - INPATIENT SUBSTANCE AND A
Facility Name THE PRAIRIE RECOVERY CENTER
Street 5808 WAGNER RD
City ROUND TOP
State TX
ZIP 78954
Phone 979 530-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Other - INPATIENT SUBSTANCE AND A
Lab Director CARLOS TIRADO

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