45D0979319 CLIA NUMBER - CONROE MONTGOMERY PHYSICIAN ASSOCIATES

Laboratory Demographics

  • CLIA Code: 45D0979319
  • Facility Name: CONROE MONTGOMERY PHYSICIAN ASSOCIATES
  • Facility Address: 508 MEDICAL CENTER BLVD STE 320
    CONROE, TX
    ZIP 77304
  • Facility Phone: 936 523-5790
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEROME C. YOUNG
  • NPI Number: 1518220094
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0979319
LAB Type Physician Office
Facility Name CONROE MONTGOMERY PHYSICIAN ASSOCIATES
Street 508 MEDICAL CENTER BLVD STE 320
City CONROE
State TX
ZIP 77304
Phone 936 523-5790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director JEROME C. YOUNG

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