45D1087988 CLIA NUMBER - FAIRWAY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D1087988
  • Facility Name: FAIRWAY MEDICAL CLINIC
  • Facility Address: 4910 TELEPHONE RD
    HOUSTON, TX
    ZIP 77087
  • Facility Phone: 713 641-3900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MURTAZA MUSSAJI
  • NPI Number: 1164679494
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1087988
LAB Type Physician Office
Facility Name FAIRWAY MEDICAL CLINIC
Street 4910 TELEPHONE RD
City HOUSTON
State TX
ZIP 77087
Phone 713 641-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2023
Certificate Expiration Date 10/6/2025
Facility Type Physician Office
Lab Director MURTAZA MUSSAJI

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