45D1107138 CLIA NUMBER - RODONAIA FAMILY MEDICINE AND AESTHETICS

Laboratory Demographics

  • CLIA Code: 45D1107138
  • Facility Name: RODONAIA FAMILY MEDICINE AND AESTHETICS
  • Facility Address: 2955 HARRISON ST STE 200
    BEAUMONT, TX
    ZIP 77702
  • Facility Phone: 409 923-1617
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GRIGORIY T. RODONAIA, MD PA
  • NPI Number: 1497992127
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1107138
LAB Type Physician Office
Facility Name RODONAIA FAMILY MEDICINE AND AESTHETICS
Street 2955 HARRISON ST STE 200
City BEAUMONT
State TX
ZIP 77702
Phone 409 923-1617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director GRIGORIY T. RODONAIA, MD PA

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