45D0490299 CLIA NUMBER - ST DOMINIC NURSING HOME

Laboratory Demographics

  • CLIA Code: 45D0490299
  • Facility Name: ST DOMINIC NURSING HOME
  • Facility Address: 2409 HOLCOMBE BLVD
    HOUSTON, TX
    ZIP 77021
  • Facility Phone: 713 741-8701
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRYANT K. SAM
  • NPI Number: 1487079851
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D0490299
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ST DOMINIC NURSING HOME
Street 2409 HOLCOMBE BLVD
City HOUSTON
State TX
ZIP 77021
Phone 713 741-8701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BRYANT K. SAM

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