45D0700266 CLIA NUMBER - BRAZOS VALLEY WOMEN'S CENTER

Laboratory Demographics

  • CLIA Code: 45D0700266
  • Facility Name: BRAZOS VALLEY WOMEN'S CENTER
  • Facility Address: 1602 ROCK PRAIRIE RD, STE 230
    COLLEGE STATION, TX
    ZIP 77845
  • Facility Phone: 979 776-5602
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: JAMIE K. SOUTH
  • NPI Number: 1134593056
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0700266
LAB Type Practitioner Other
Facility Name BRAZOS VALLEY WOMEN'S CENTER
Street 1602 ROCK PRAIRIE RD, STE 230
City COLLEGE STATION
State TX
ZIP 77845
Phone 979 776-5602
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Practitioner Other
Lab Director JAMIE K. SOUTH

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