45D2076568 CLIA NUMBER - PINE PARK DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D2076568
  • Facility Name: PINE PARK DIALYSIS
  • Facility Address: 3333 BAYSHORE BLVD
    PASADENA, TX
    ZIP 77504
  • Facility Phone: 713 943-1171
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: TAHIR HAFEEZ
  • NPI Number: 1457773368
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2076568
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PINE PARK DIALYSIS
Street 3333 BAYSHORE BLVD
City PASADENA
State TX
ZIP 77504
Phone 713 943-1171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director TAHIR HAFEEZ

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