45D2133557 CLIA NUMBER - GRACE FAMILY CLINIC LLC

Laboratory Demographics

CLIA Number: 45D2133557

Facility Name: GRACE FAMILY CLINIC LLC

Facility Address:
2435 TEXAS PARKWAY SUITE K
MISSOURI CITY, TX
ZIP 77489
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Facility Phone Number: 832 493-4178

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1093244832

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D2133557
LAB Type	Practitioner Other
Facility Name	GRACE FAMILY CLINIC LLC
Street	2435 TEXAS PARKWAY SUITE K
City	MISSOURI CITY
State	TX
ZIP	77489
Phone	832 493-4178
CertificateType	4
CertificateEffectiveDate	7/14/2023
CertificateExpirationDate	7/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024