45D0987987 CLIA NUMBER - VA OUTPATIENT CLINIC - BEAUMONT

Laboratory Demographics

  • CLIA Code: 45D0987987
  • Facility Name: VA OUTPATIENT CLINIC - BEAUMONT
  • Facility Address: 3420 VETERANS CIRCLE 1ST FL RM 106
    BEAUMONT, TX
    ZIP 77707
  • Facility Phone: 409 981-8570
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: MICHAEL M. ITTMANN
  • NPI Number: 1861665572
  • Taxonomy: 332100000X - Department of Veterans Affairs (VA) Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D0987987
LAB Type Community Clinic
Facility Name VA OUTPATIENT CLINIC - BEAUMONT
Street 3420 VETERANS CIRCLE 1ST FL RM 106
City BEAUMONT
State TX
ZIP 77707
Phone 409 981-8570
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/19/2001
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director MICHAEL M. ITTMANN

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