45D1047182 CLIA NUMBER - MED SOURCE HEALTHCARE SERVICES INC

Laboratory Demographics

  • CLIA Code: 45D1047182
  • Facility Name: MED SOURCE HEALTHCARE SERVICES INC
  • Facility Address: 12926 DAIRY ASHFORD STE #150
    SUGAR LAND, TX
    ZIP 77478
  • Facility Phone: 281 265-0095
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: PRISCILLA UDEAGHA
  • NPI Number: 1902144660
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 45D1047182
LAB Type Home Health Agency
Facility Name MED SOURCE HEALTHCARE SERVICES INC
Street 12926 DAIRY ASHFORD STE #150
City SUGAR LAND
State TX
ZIP 77478
Phone 281 265-0095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Home Health Agency
Lab Director PRISCILLA UDEAGHA

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