45D1001062 CLIA NUMBER - MITZI T JIMENEZ, MD PA

Laboratory Demographics

  • CLIA Code: 45D1001062
  • Facility Name: MITZI T JIMENEZ, MD PA
  • Facility Address: 910 S WAYSIDE, SUITE 150
    HOUSTON, TX
    ZIP 77023
  • Facility Phone: 713 923-6333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MITZI T. JIMENEZ
  • NPI Number: 1912941774
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1001062
LAB Type Physician Office
Facility Name MITZI T JIMENEZ, MD PA
Street 910 S WAYSIDE, SUITE 150
City HOUSTON
State TX
ZIP 77023
Phone 713 923-6333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Physician Office
Lab Director MITZI T. JIMENEZ

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This page was last updated on: 6/4/2025