45D1102977 CLIA NUMBER - T C JESTER DIALYSIS

Laboratory Demographics

CLIA Number: 45D1102977

Facility Name: T C JESTER DIALYSIS

Facility Address:
1800 WEST 26TH ST STE 101
HOUSTON, TX
ZIP 77008
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Facility Phone Number: 713 863-0463

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1982831343

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D1102977
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	T C JESTER DIALYSIS
Street	1800 WEST 26TH ST STE 101
City	HOUSTON
State	TX
ZIP	77008
Phone	713 863-0463
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

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