45D2061147 CLIA NUMBER - VICTORY LAKES DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D2061147
  • Facility Name: VICTORY LAKES DIALYSIS
  • Facility Address: 3290 GULF FREEWAY
    LEAGUE CITY, TX
    ZIP 77573
  • Facility Phone: 281 534-3171
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: TINA KOCHAR
  • NPI Number: 1003169269
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 45D2061147
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VICTORY LAKES DIALYSIS
Street 3290 GULF FREEWAY
City LEAGUE CITY
State TX
ZIP 77573
Phone 281 534-3171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director TINA KOCHAR

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