45D1051418 CLIA NUMBER - VILLAGEMD OF SOUTHEAST TEXAS, PA

Laboratory Demographics

  • CLIA Code: 45D1051418
  • Facility Name: VILLAGEMD OF SOUTHEAST TEXAS, PA
  • Facility Address: 9055 KATY FRWY, SUITE 100, 200, 306
    HOUSTON, TX
    ZIP 77024
  • Facility Phone: (346) 980-2236
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEX SU MD
  • NPI Number: 1841643327
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1051418
LAB Type Physician Office
Facility Name VILLAGEMD OF SOUTHEAST TEXAS, PA
Street 9055 KATY FRWY, SUITE 100, 200, 306
City HOUSTON
State TX
ZIP 77024
Phone 3469802236
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2026
Certificate Expiration Date 2/29/2028
Facility Type Physician Office
Lab Director ALEX SU MD

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This page was last updated on: 6/29/2026