45D2136167 CLIA NUMBER - RICELAND CLINIC VIDOR

Laboratory Demographics

  • CLIA Code: 45D2136167
  • Facility Name: RICELAND CLINIC VIDOR
  • Facility Address: 20925 IH 10
    VIDOR, TX
    ZIP 77662
  • Facility Phone: 409 769-2295
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES L. SLAYTON JR
  • NPI Number: 1376937003
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2136167
LAB Type Physician Office
Facility Name RICELAND CLINIC VIDOR
Street 20925 IH 10
City VIDOR
State TX
ZIP 77662
Phone 409 769-2295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Physician Office
Lab Director JAMES L. SLAYTON JR

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