45D2114527 CLIA NUMBER - ELIAS EZIKE, MD, PA

Laboratory Demographics

  • CLIA Code: 45D2114527
  • Facility Name: ELIAS EZIKE, MD, PA
  • Facility Address: 87 INTERSTATE 10 N SUITE 221
    BEAUMONT, TX
    ZIP 77707
  • Facility Phone: 409 838-9944
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELIAS N. EZIKE
  • NPI Number: 1811902307
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2114527
LAB Type Physician Office
Facility Name ELIAS EZIKE, MD, PA
Street 87 INTERSTATE 10 N SUITE 221
City BEAUMONT
State TX
ZIP 77707
Phone 409 838-9944
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Physician Office
Lab Director ELIAS N. EZIKE

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