45D2308456 CLIA NUMBER - WALLER HARRIS ESD 200

Laboratory Demographics

  • CLIA Code: 45D2308456
  • Facility Name: WALLER HARRIS ESD 200
  • Facility Address: 540 ELLEN POWELL
    PRAIRIE VIEW, TX
    ZIP 77446
  • Facility Phone: 936 372-8084
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BRAD GOUDE
  • NPI Number: 1437994274
  • Taxonomy: 3416L0300X - Ambulance

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2308456
LAB Type Ambulance
Facility Name WALLER HARRIS ESD 200
Street 540 ELLEN POWELL
City PRAIRIE VIEW
State TX
ZIP 77446
Phone 936 372-8084
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Ambulance
Lab Director BRAD GOUDE

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