45D2160953 CLIA NUMBER - PINE MEDICAL PLLC

Laboratory Demographics

  • CLIA Code: 45D2160953
  • Facility Name: PINE MEDICAL PLLC
  • Facility Address: 1412 S FRONT ST
    BELLVILLE, TX
    ZIP 77418
  • Facility Phone: 832 844-0934
  • Facility Type: Other - URGENT CARE CLINIC
  • Facility Type: Waiver
  • Lab Director: MOROMOKE O. ODINA
  • NPI Number: 1598232035
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2160953
LAB Type Other - URGENT CARE CLINIC
Facility Name PINE MEDICAL PLLC
Street 1412 S FRONT ST
City BELLVILLE
State TX
ZIP 77418
Phone 832 844-0934
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2025
Certificate Expiration Date 1/22/2027
Facility Type Other - URGENT CARE CLINIC
Lab Director MOROMOKE O. ODINA

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