45D0974452 CLIA NUMBER - TEXAS CHILDREN'S PEDIATRICS PALM CENTER

Laboratory Demographics

CLIA Number: 45D0974452

Facility Name: TEXAS CHILDREN'S PEDIATRICS PALM CENTER

Facility Address:
5400 GRIGGS ROAD SUITE 100
HOUSTON, TX
ZIP 77021
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Facility Phone Number: 713 741-4078

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1629498498

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	45D0974452
LAB Type	Physician Office
Facility Name	TEXAS CHILDREN'S PEDIATRICS PALM CENTER
Street	5400 GRIGGS ROAD SUITE 100
City	HOUSTON
State	TX
ZIP	77021
Phone	713 741-4078
CertificateType	4
CertificateEffectiveDate	6/7/2022
CertificateExpirationDate	6/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024