45D2050056 CLIA NUMBER - SHADOW CREEK MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D2050056
  • Facility Name: SHADOW CREEK MEDICAL CLINIC
  • Facility Address: 11021 SHADOW CREEK PKWY #102
    PEARLAND, TX
    ZIP 77584
  • Facility Phone: 713 340-1977
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MURTAZA MUSSAJI

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CLIA Record

Field Name Field Value
CLIA Number 45D2050056
LAB Type Physician Office
Facility Name SHADOW CREEK MEDICAL CLINIC
Street 11021 SHADOW CREEK PKWY #102
City PEARLAND
State TX
ZIP 77584
Phone 713 340-1977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Physician Office
Lab Director MURTAZA MUSSAJI

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This page was last updated on: 6/4/2025