45D0054055 CLIA NUMBER - MEMORIAL MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 45D0054055
  • Facility Name: MEMORIAL MEDICAL CENTER
  • Facility Address: 815 VIRGINIA N STREET
    PORT LAVACA, TX
    ZIP 77979
  • Facility Phone: 361 552-0284
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: BRYAN JANSSEN
  • NPI Number: 1104203181
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 45D0054055
LAB Type Hospital
Facility Name MEMORIAL MEDICAL CENTER
Street 815 VIRGINIA N STREET
City PORT LAVACA
State TX
ZIP 77979
Phone 361 552-0284
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Hospital
Lab Director BRYAN JANSSEN

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