45D1103991 CLIA NUMBER - SMITH & SMITH PLLC

Laboratory Demographics

CLIA Number: 45D1103991

Facility Name: SMITH & SMITH PLLC

Facility Address:
2955 HARRISON STE 301
BEAUMONT, TX
ZIP 77702
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Facility Phone Number: 409 898-2301

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1700019239

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	45D1103991
LAB Type	Practitioner Other
Facility Name	SMITH & SMITH PLLC
Street	2955 HARRISON STE 301
City	BEAUMONT
State	TX
ZIP	77702
Phone	409 898-2301
CertificateType	4
CertificateEffectiveDate	8/21/2023
CertificateExpirationDate	8/20/2025
FacilityType	Waiver

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