45D2160136 CLIA NUMBER - SUNRISE FAMILY CLINIC PA

Laboratory Demographics

CLIA Number: 45D2160136

Facility Name: SUNRISE FAMILY CLINIC PA

Facility Address:
6725 ATASCOCITA RD, SUITE A
HUMBLE, TX
ZIP 77346
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Facility Phone Number: 281 812-3990

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720586753

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	45D2160136
LAB Type	Physician Office
Facility Name	SUNRISE FAMILY CLINIC PA
Street	6725 ATASCOCITA RD, SUITE A
City	HUMBLE
State	TX
ZIP	77346
Phone	281 812-3990
CertificateType	4
CertificateEffectiveDate	1/4/2023
CertificateExpirationDate	1/3/2025
FacilityType	Waiver

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