45D2100618 CLIA NUMBER - WEST COLUMBIA CLINIC

Laboratory Demographics

  • CLIA Code: 45D2100618
  • Facility Name: WEST COLUMBIA CLINIC
  • Facility Address: 411 W BRAZOS AVE
    WEST COLUMBIA, TX
    ZIP 77486
  • Facility Phone: 979 345-2525
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY L. KEFFER
  • NPI Number: 1770081028
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2100618
LAB Type Physician Office
Facility Name WEST COLUMBIA CLINIC
Street 411 W BRAZOS AVE
City WEST COLUMBIA
State TX
ZIP 77486
Phone 979 345-2525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Physician Office
Lab Director AMY L. KEFFER

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