45D0707642 CLIA NUMBER - FEDERAL PRISON CAMP BRYAN

Laboratory Demographics

  • CLIA Code: 45D0707642
  • Facility Name: FEDERAL PRISON CAMP BRYAN
  • Facility Address: 1100 URSULINE
    BRYAN, TX
    ZIP 77803
  • Facility Phone: 409 823-1879
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: CASSIDY BROWN
  • NPI Number: 1992061188
  • Taxonomy: 261QP2400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0707642
LAB Type Other
Facility Name FEDERAL PRISON CAMP BRYAN
Street 1100 URSULINE
City BRYAN
State TX
ZIP 77803
Phone 409 823-1879
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 Other
Lab Director CASSIDY BROWN

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