45D1033258 CLIA NUMBER - JACINTO CITY FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 45D1033258
  • Facility Name: JACINTO CITY FIRE DEPARTMENT
  • Facility Address: 1126 MERCURY DRIVE
    HOUSTON, TX
    ZIP 77029
  • Facility Phone: (713) 674-8424
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MIKE M. BODAK
  • NPI Number: 1215130174
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 45D1033258
LAB Type Ambulance
Facility Name JACINTO CITY FIRE DEPARTMENT
Street 1126 MERCURY DRIVE
City HOUSTON
State TX
ZIP 77029
Phone 7136748424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Ambulance
Lab Director MIKE M. BODAK

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This page was last updated on: 5/15/2026