45D1059554 CLIA NUMBER - PRIMARY CARE PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 45D1059554
  • Facility Name: PRIMARY CARE PEDIATRICS PA
  • Facility Address: 8333 9TH AVENUE SUITE B
    PORT ARTHUR, TX
    ZIP 77642
  • Facility Phone: 409 729-9200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINDA L. TOLEDO, MD
  • NPI Number: 1417006735
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1059554
LAB Type Physician Office
Facility Name PRIMARY CARE PEDIATRICS PA
Street 8333 9TH AVENUE SUITE B
City PORT ARTHUR
State TX
ZIP 77642
Phone 409 729-9200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Physician Office
Lab Director MINDA L. TOLEDO, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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