45D0498404 CLIA NUMBER - LEGACY NURSING & REHABILITATION

Laboratory Demographics

  • CLIA Code: 45D0498404
  • Facility Name: LEGACY NURSING & REHABILITATION
  • Facility Address: 2817 KENT STREET
    BRYAN, TX
    ZIP 77802
  • Facility Phone: 979 776-7521
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. LAVALAIS
  • NPI Number: 1215404330
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D0498404
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LEGACY NURSING & REHABILITATION
Street 2817 KENT STREET
City BRYAN
State TX
ZIP 77802
Phone 979 776-7521
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 JENNIFER L. LAVALAIS

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This page was last updated on: 6/4/2025