45D0975485 CLIA NUMBER - COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TX INC LULING COMMUNITY HEALTH CENTER

Laboratory Demographics

CLIA Code: 45D0975485
Facility Name: COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TX INC LULING COMMUNITY HEALTH CENTER
Facility Address: 111 SOUTH LAUREL
LULING, TX
ZIP 78648
Facility Phone: 830 875-6399
Facility Type: Federally Qualified Health Center
Facility Type: Microscopy
Lab Director: ROLAND MEDELLIN
NPI Number: 1396904686
Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name	Field Value
CLIA Number	45D0975485
LAB Type	Federally Qualified Health Center
Facility Name	COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TX INC LULING COMMUNITY HEALTH CENTER
Street	111 SOUTH LAUREL
City	LULING
State	TX
ZIP	78648
Phone	830 875-6399
Certificate Type	Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description	This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date	9/10/2024
Certificate Expiration Date	9/9/2026
Facility Type	Federally Qualified Health Center
Lab Director	ROLAND MEDELLIN

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