45D0978428 CLIA NUMBER - SUGAR LAKES FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 45D0978428

Facility Name: SUGAR LAKES FAMILY PRACTICE

Facility Address:
16902 SOUTHWEST FREEWAY SUITE 100
SUGAR LAND, TX
ZIP 77479
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Facility Phone Number: 281 565-2800

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1588789986

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	45D0978428
LAB Type	Physician Office
Facility Name	SUGAR LAKES FAMILY PRACTICE
Street	16902 SOUTHWEST FREEWAY SUITE 100
City	SUGAR LAND
State	TX
ZIP	77479
Phone	281 565-2800
CertificateType	3
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	PPMP

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