Organization
CITY OF LUBBOCK HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLOYCE STETSON M.D. (MEDICAL DIRECTOR)
(806) 743-2463
Entity
Organization
Contact information
Practice address
1902 TEXAS AVE, LUBBOCK, TX 79411
(806) 775-2906
(806) 775-3178
Mailing address
1902 TEXAS AVE, LUBBOCK, TX 79411
(806) 775-2906
(806) 775-3178
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLIA 45D0660644
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135103303
—
TX
Enumeration date
05/04/2007
Last updated
05/20/2010
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