45D2121610 CLIA NUMBER - NATRAJ SHANMUGAM MD PA

Laboratory Demographics

  • CLIA Code: 45D2121610
  • Facility Name: NATRAJ SHANMUGAM MD PA
  • Facility Address: 1602 ROCK PRAIRIE ROAD, SUITE 210
    COLLEGE STATION, TX
    ZIP 77845
  • Facility Phone: 979 696-5663
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NATRAJ A. SHANMUGAM
  • NPI Number: 1700338068
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2121610
LAB Type Physician Office
Facility Name NATRAJ SHANMUGAM MD PA
Street 1602 ROCK PRAIRIE ROAD, SUITE 210
City COLLEGE STATION
State TX
ZIP 77845
Phone 979 696-5663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director NATRAJ A. SHANMUGAM

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