45D2137856 CLIA NUMBER - LAKE AREA IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 45D2137856
  • Facility Name: LAKE AREA IMAGING CENTER
  • Facility Address: 18057 TX 105 SUITE #250
    MONTGOMERY, TX
    ZIP 77356
  • Facility Phone: 936 539-7714
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: PAUL ALLISON
  • NPI Number: 1285645911
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2137856
LAB Type Ancillary Testing Site in Health Care Center
Facility Name LAKE AREA IMAGING CENTER
Street 18057 TX 105 SUITE #250
City MONTGOMERY
State TX
ZIP 77356
Phone 936 539-7714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2023
Certificate Expiration Date 10/3/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director PAUL ALLISON

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