45D1079160 CLIA NUMBER - GREENWOOD HOLLY RENAL CENTER

Laboratory Demographics

  • CLIA Code: 45D1079160
  • Facility Name: GREENWOOD HOLLY RENAL CENTER
  • Facility Address: 1533 HOLLY ROAD
    CORPUS CHRISTI, TX
    ZIP 78417
  • Facility Phone: 361 850-7330
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHAH ISLAM
  • NPI Number: 1093998940
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1079160
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GREENWOOD HOLLY RENAL CENTER
Street 1533 HOLLY ROAD
City CORPUS CHRISTI
State TX
ZIP 78417
Phone 361 850-7330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHAH ISLAM

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This page was last updated on: 6/4/2025