45D2014870 CLIA NUMBER - PREMISE HEALTH OF TEXAS MEDICAL, PA

Laboratory Demographics

  • CLIA Code: 45D2014870
  • Facility Name: PREMISE HEALTH OF TEXAS MEDICAL, PA
  • Facility Address: 1701 EAST MOSSY OAKS ROAD SUITE 1 W, STE 319
    SPRING, TX
    ZIP 77389
  • Facility Phone: 281 251-3049
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA BRADY
  • NPI Number: 1871018440
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 45D2014870
LAB Type Physician Office
Facility Name PREMISE HEALTH OF TEXAS MEDICAL, PA
Street 1701 EAST MOSSY OAKS ROAD SUITE 1 W, STE 319
City SPRING
State TX
ZIP 77389
Phone 281 251-3049
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Physician Office
Lab Director JESSICA BRADY

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This page was last updated on: 3/20/2025