45D1031198 CLIA NUMBER - GARY R MENNIE, MD, PA

Laboratory Demographics

  • CLIA Code: 45D1031198
  • Facility Name: GARY R MENNIE, MD, PA
  • Facility Address: 2770 AERO DR STE 1
    PORT ARTHUR, TX
    ZIP 77640
  • Facility Phone: (409) 727-4642
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY R. MENNIE
  • NPI Number: 1235131210
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D1031198
LAB Type Physician Office
Facility Name GARY R MENNIE, MD, PA
Street 2770 AERO DR STE 1
City PORT ARTHUR
State TX
ZIP 77640
Phone 4097274642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Physician Office
Lab Director GARY R. MENNIE

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This page was last updated on: 5/18/2026