45D2035019 CLIA NUMBER - CHRISTUS TRINITY CLINIC - PORTLAND

Laboratory Demographics

  • CLIA Code: 45D2035019
  • Facility Name: CHRISTUS TRINITY CLINIC - PORTLAND
  • Facility Address: 311 BUDDY GANEM DRIVE, SUITE A
    PORTLAND, TX
    ZIP 78374
  • Facility Phone: 361 777-0500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JORGE A. RAMIREZ
  • NPI Number: 1821282583
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2035019
LAB Type Physician Office
Facility Name CHRISTUS TRINITY CLINIC - PORTLAND
Street 311 BUDDY GANEM DRIVE, SUITE A
City PORTLAND
State TX
ZIP 78374
Phone 361 777-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Physician Office
Lab Director JORGE A. RAMIREZ

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