45D2150744 CLIA NUMBER - DAVID MEDUNA, MD PA

Laboratory Demographics

  • CLIA Code: 45D2150744
  • Facility Name: DAVID MEDUNA, MD PA
  • Facility Address: 1602 ROCK PRAIRIE RD EAST BLDG, SUITE 3100
    COLLEGE STATION, TX
    ZIP 77845
  • Facility Phone: 979 764-6868
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID MEDUNA
  • NPI Number: 1902816242
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 45D2150744
LAB Type Physician Office
Facility Name DAVID MEDUNA, MD PA
Street 1602 ROCK PRAIRIE RD EAST BLDG, SUITE 3100
City COLLEGE STATION
State TX
ZIP 77845
Phone 979 764-6868
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Physician Office
Lab Director DAVID MEDUNA

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