45D2044533 CLIA NUMBER - KINGHAVEN COUNSELING GROUP, INC

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Laboratory Demographics

CLIA Number: 45D2044533

Facility Name: KINGHAVEN COUNSELING GROUP, INC

Facility Address:
11811 FM 1960 W STE 130
HOUSTON, TX
ZIP 77065
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Facility Phone Number: 713 457-4372

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396807350

Taxonomy: 101YP2500X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	45D2044533
LAB Type	Physician Office
Facility Name	KINGHAVEN COUNSELING GROUP, INC
Street	11811 FM 1960 W STE 130
City	HOUSTON
State	TX
ZIP	77065
Phone	713 457-4372
CertificateType	4
CertificateEffectiveDate	6/29/2023
CertificateExpirationDate	6/28/2025
FacilityType	Waiver

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