45D0660287 CLIA NUMBER - MAGNOLIA PLACE HEALTH CARE

Laboratory Demographics

  • CLIA Code: 45D0660287
  • Facility Name: MAGNOLIA PLACE HEALTH CARE
  • Facility Address: 1620 MAGNOLIA ST
    LIBERTY, TX
    ZIP 77575
  • Facility Phone: 936 336-8844
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ADAM C. OTT
  • NPI Number: 1033114319
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D0660287
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MAGNOLIA PLACE HEALTH CARE
Street 1620 MAGNOLIA ST
City LIBERTY
State TX
ZIP 77575
Phone 936 336-8844
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 ADAM C. OTT

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