45D0489337 CLIA NUMBER - SAN JOSE CLINIC

Laboratory Demographics

  • CLIA Code: 45D0489337
  • Facility Name: SAN JOSE CLINIC
  • Facility Address: 2615 FANNIN ST
    HOUSTON, TX
    ZIP 77002
  • Facility Phone: 713 490-2617
  • Facility Type: Other - CHARITABLE NON PROFIT
  • Facility Type: Waiver
  • Lab Director: MICHAEL RYTTING
  • NPI Number: 1750674321
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0489337
LAB Type Other - CHARITABLE NON PROFIT
Facility Name SAN JOSE CLINIC
Street 2615 FANNIN ST
City HOUSTON
State TX
ZIP 77002
Phone 713 490-2617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Other - CHARITABLE NON PROFIT
Lab Director MICHAEL RYTTING

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This page was last updated on: 3/20/2025