45D2095783 CLIA NUMBER - PHYSICIANS PREMIER ER PORTLAND

Laboratory Demographics

  • CLIA Code: 45D2095783
  • Facility Name: PHYSICIANS PREMIER ER PORTLAND
  • Facility Address: 1860 HWY FRONTAGE ROAD, STE C
    PORTLAND, TX
    ZIP 78374
  • Facility Phone: 832 725-8717
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. PAUL D. KENYON
  • NPI Number: 1093191397
  • Taxonomy: 261QE0002X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2095783
LAB Type Physician Office
Facility Name PHYSICIANS PREMIER ER PORTLAND
Street 1860 HWY FRONTAGE ROAD, STE C
City PORTLAND
State TX
ZIP 78374
Phone 832 725-8717
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Physician Office
Lab Director DR. PAUL D. KENYON

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