45D0966196 CLIA NUMBER - PRIME MEDIC PA

Laboratory Demographics

  • CLIA Code: 45D0966196
  • Facility Name: PRIME MEDIC PA
  • Facility Address: 211 S COLLEGE AVE
    CLEVELAND, TX
    ZIP 77327
  • Facility Phone: 281 592-8622
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SREENIVASULU CHERLO
  • NPI Number: 1255432829
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0966196
LAB Type Physician Office
Facility Name PRIME MEDIC PA
Street 211 S COLLEGE AVE
City CLEVELAND
State TX
ZIP 77327
Phone 281 592-8622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2025
Certificate Expiration Date 10/7/2027
Facility Type Physician Office
Lab Director SREENIVASULU CHERLO

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