45D1084006 CLIA NUMBER - SHANNON JUNO MD

Laboratory Demographics

  • CLIA Code: 45D1084006
  • Facility Name: SHANNON JUNO MD
  • Facility Address: 1720 N VONMINDEN
    LA GRANGE, TX
    ZIP 78945
  • Facility Phone: 979 968-2700
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHANNON JUNO MD
  • NPI Number: 1104818624
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D1084006
LAB Type Physician Office
Facility Name SHANNON JUNO MD
Street 1720 N VONMINDEN
City LA GRANGE
State TX
ZIP 78945
Phone 979 968-2700
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director SHANNON JUNO MD

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