Shannon Clinic Reference Lab

LBN: Shannon Clinic Reference Lab
Shannon Clinic Reference Lab is an health care organization with primary practice located at 120 E Beauregard Ave , San Angelo TX 76903-5919. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Shannon Clinic Reference Lab can be contacted via phone (325) 658-1511, or through Villarreal, Ricardo via phone (325) 481-8248.

Contact Information

Primary practice address
120 E Beauregard Ave San Angelo TX 76903-5919
Phone: (325) 658-1511
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Villarreal, Ricardo
Phone: (325) 481-8248

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1114119385
LBN Legal business name Shannon Clinic Reference Lab
DBA Doing business as
Authorized official Villarreal, Ricardo
Entity Organization
Organization subpart 1 No
Enumeration date Aug 13th, 2007
Last updated Jan 21st, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114119385 NPPES
Texas MEDICAID 127005001

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