45D0722203 CLIA NUMBER - MID COUNTY FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 45D0722203
  • Facility Name: MID COUNTY FAMILY CLINIC
  • Facility Address: 2501 JIMMY JOHNSON BLVD # 405
    PORT ARTHUR, TX
    ZIP 77640
  • Facility Phone: 409 727-4422
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRANK J. KOTZUR
  • NPI Number: 1427562891
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0722203
LAB Type Physician Office
Facility Name MID COUNTY FAMILY CLINIC
Street 2501 JIMMY JOHNSON BLVD # 405
City PORT ARTHUR
State TX
ZIP 77640
Phone 409 727-4422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Physician Office
Lab Director FRANK J. KOTZUR

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