45D0863789 CLIA NUMBER - UNIVERSITY OF TEXAS WIC PROGRAM

Laboratory Demographics

  • CLIA Code: 45D0863789
  • Facility Name: UNIVERSITY OF TEXAS WIC PROGRAM
  • Facility Address: 2636 S LOOP WEST #625
    HOUSTON, TX
    ZIP 77054
  • Facility Phone: 713 728-8590
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: KAREN L. GIBSON
  • NPI Number: 1821045592
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 45D0863789
LAB Type Community Clinic
Facility Name UNIVERSITY OF TEXAS WIC PROGRAM
Street 2636 S LOOP WEST #625
City HOUSTON
State TX
ZIP 77054
Phone 713 728-8590
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 Community Clinic
Lab Director KAREN L. GIBSON

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