45D2143850 CLIA NUMBER - LEENA CHACKO MD PA DBA FAMILY & AGING CENTER

Laboratory Demographics

  • CLIA Code: 45D2143850
  • Facility Name: LEENA CHACKO MD PA DBA FAMILY & AGING CENTER
  • Facility Address: 17320 RED OAK DRIVE SUITE 260
    HOUSTON, TX
    ZIP 77090
  • Facility Phone: 832 295-9829
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LEENA CHACKO
  • NPI Number: 1609002138
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2143850
LAB Type Physician Office
Facility Name LEENA CHACKO MD PA DBA FAMILY & AGING CENTER
Street 17320 RED OAK DRIVE SUITE 260
City HOUSTON
State TX
ZIP 77090
Phone 832 295-9829
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Physician Office
Lab Director LEENA CHACKO

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