45D0965514 CLIA NUMBER - MEDAGENE CLINIC

Laboratory Demographics

  • CLIA Code: 45D0965514
  • Facility Name: MEDAGENE CLINIC
  • Facility Address: 6655 HILLCROFT SUITE 105
    HOUSTON, TX
    ZIP 77081
  • Facility Phone: 713 779-1633
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: GONZALO URIBE-BOTERO
  • NPI Number: 1932487949
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D0965514
LAB Type Community Clinic
Facility Name MEDAGENE CLINIC
Street 6655 HILLCROFT SUITE 105
City HOUSTON
State TX
ZIP 77081
Phone 713 779-1633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Community Clinic
Lab Director GONZALO URIBE-BOTERO

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