45D2088362 CLIA NUMBER - DIAGNOSTIC GROUP INTEGRATED HEALTHCARE

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Laboratory Demographics

CLIA Number: 45D2088362

Facility Name: DIAGNOSTIC GROUP INTEGRATED HEALTHCARE

Facility Address:
2200 HWY 365
NEDERLAND, TX
ZIP 77627
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Facility Phone Number: 409 730-2022

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1427413723

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2088362
LAB Type	Physician Office
Facility Name	DIAGNOSTIC GROUP INTEGRATED HEALTHCARE
Street	2200 HWY 365
City	NEDERLAND
State	TX
ZIP	77627
Phone	409 730-2022
CertificateType	4
CertificateEffectiveDate	12/15/2022
CertificateExpirationDate	12/14/2024
FacilityType	Waiver

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