45D2163899 CLIA NUMBER - CENIKOR FOUNDATION- ODYSSEY HOUSE

Laboratory Demographics

  • CLIA Code: 45D2163899
  • Facility Name: CENIKOR FOUNDATION- ODYSSEY HOUSE
  • Facility Address: 5629 GRAPEVINE STREET
    HOUSTON, TX
    ZIP 77085
  • Facility Phone: 713 266-9944
  • Facility Type: Other - SUBSTANCE ABUSE TREATMENT
  • Facility Type: Waiver
  • Lab Director: DERRICK LOTT
  • NPI Number: 1669695243
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2163899
LAB Type Other - SUBSTANCE ABUSE TREATMENT
Facility Name CENIKOR FOUNDATION- ODYSSEY HOUSE
Street 5629 GRAPEVINE STREET
City HOUSTON
State TX
ZIP 77085
Phone 713 266-9944
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Other - SUBSTANCE ABUSE TREATMENT
Lab Director DERRICK LOTT

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