45D0962814 CLIA NUMBER - LEGACY COMMUNITY HEALTH - SANTA CLARA

Laboratory Demographics

  • CLIA Code: 45D0962814
  • Facility Name: LEGACY COMMUNITY HEALTH - SANTA CLARA
  • Facility Address: 5616 LAWNDALE, SUITE A108
    HOUSTON, TX
    ZIP 77023
  • Facility Phone: 713 814-3293
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: CYNTHIA ROLAND
  • NPI Number: 1437402781
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0962814
LAB Type Federally Qualified Health Center
Facility Name LEGACY COMMUNITY HEALTH - SANTA CLARA
Street 5616 LAWNDALE, SUITE A108
City HOUSTON
State TX
ZIP 77023
Phone 713 814-3293
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Federally Qualified Health Center
Lab Director CYNTHIA ROLAND

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This page was last updated on: 3/20/2025