45D2056787 CLIA NUMBER - UTMB LONE STAR WIC

Laboratory Demographics

  • CLIA Code: 45D2056787
  • Facility Name: UTMB LONE STAR WIC
  • Facility Address: 605 SOUTH CONROE MEDICAL
    CONROE, TX
    ZIP 77304
  • Facility Phone: 409 772-2388
  • Facility Type: Other - WIC
  • Facility Type: Waiver
  • Lab Director: JEROME L. YAKLIC

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CLIA Record

Field Name Field Value
CLIA Number 45D2056787
LAB Type Other - WIC
Facility Name UTMB LONE STAR WIC
Street 605 SOUTH CONROE MEDICAL
City CONROE
State TX
ZIP 77304
Phone 409 772-2388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2023
Certificate Expiration Date 4/2/2025
Facility Type Other - WIC
Lab Director JEROME L. YAKLIC

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