45D1066289 CLIA NUMBER - WINNIE COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 45D1066289
  • Facility Name: WINNIE COMMUNITY CLINIC
  • Facility Address: 538 BROADWAY WINNIE COMM HOSP BLDG
    WINNIE, TX
    ZIP 77665
  • Facility Phone: 409 296-6392
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: NEDRANA BOUTTE
  • NPI Number: 1780127084
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D1066289
LAB Type Rural Health Clinic
Facility Name WINNIE COMMUNITY CLINIC
Street 538 BROADWAY WINNIE COMM HOSP BLDG
City WINNIE
State TX
ZIP 77665
Phone 409 296-6392
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Rural Health Clinic
Lab Director NEDRANA BOUTTE

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