45D2111704 CLIA NUMBER - NASA PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 45D2111704
  • Facility Name: NASA PEDIATRICS PLLC
  • Facility Address: 4014 WOODLAWN AVE, SUITE A
    PASADENA, TX
    ZIP 77504
  • Facility Phone: 281 464-3780
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IDALIA R. RIVERA-MATOS
  • NPI Number: 1235508805
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D2111704
LAB Type Physician Office
Facility Name NASA PEDIATRICS PLLC
Street 4014 WOODLAWN AVE, SUITE A
City PASADENA
State TX
ZIP 77504
Phone 281 464-3780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Physician Office
Lab Director IDALIA R. RIVERA-MATOS

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This page was last updated on: 3/20/2025