45D1071254 CLIA NUMBER - GLEN G GUILLET MD PA

Laboratory Demographics

CLIA Number: 45D1071254

Facility Name: GLEN G GUILLET MD PA

Facility Address:
5875 N MAJOR DR STE 214
BEAUMONT, TX
ZIP 77713
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Facility Phone Number: 409 896-5901

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1326059577

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D1071254
LAB Type	Physician Office
Facility Name	GLEN G GUILLET MD PA
Street	5875 N MAJOR DR STE 214
City	BEAUMONT
State	TX
ZIP	77713
Phone	409 896-5901
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024