45D1092548 CLIA NUMBER - PHILIP A WALLER, MD, PA

Laboratory Demographics

  • CLIA Code: 45D1092548
  • Facility Name: PHILIP A WALLER, MD, PA
  • Facility Address: 11003 RESOURCE PARKWAY SUITE 102
    HOUSTON, TX
    ZIP 77089
  • Facility Phone: 281 481-8557
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: PHILIP WALLER
  • NPI Number: 1588630578
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1092548
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PHILIP A WALLER, MD, PA
Street 11003 RESOURCE PARKWAY SUITE 102
City HOUSTON
State TX
ZIP 77089
Phone 281 481-8557
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director PHILIP WALLER

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