45D2004262 CLIA NUMBER - ALEXANDRA PELLICENA MD PA

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Laboratory Demographics

CLIA Number: 45D2004262

Facility Name: ALEXANDRA PELLICENA MD PA

Facility Address:
1919 NORTH LOOP WEST # 215
HOUSTON, TX
ZIP 77008
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Facility Phone Number: 713 370-7325

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982184321

Taxonomy: 101YP2500X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	45D2004262
LAB Type	Physician Office
Facility Name	ALEXANDRA PELLICENA MD PA
Street	1919 NORTH LOOP WEST # 215
City	HOUSTON
State	TX
ZIP	77008
Phone	713 370-7325
CertificateType	4
CertificateEffectiveDate	3/2/2024
CertificateExpirationDate	3/1/2026
FacilityType	Waiver

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