45D2115117 CLIA NUMBER - TEXAS STATE OPTICAL CHAMPIONS

Laboratory Demographics

  • CLIA Code: 45D2115117
  • Facility Name: TEXAS STATE OPTICAL CHAMPIONS
  • Facility Address: 5774 CYPRESS CREEK PARKWAY
    HOUSTON, TX
    ZIP 77069
  • Facility Phone: 281 440-5887
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: AYESHA R. BUTT
  • NPI Number: 1063639698
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 45D2115117
LAB Type Practitioner Other
Facility Name TEXAS STATE OPTICAL CHAMPIONS
Street 5774 CYPRESS CREEK PARKWAY
City HOUSTON
State TX
ZIP 77069
Phone 281 440-5887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Practitioner Other
Lab Director AYESHA R. BUTT

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