45D2171406 CLIA NUMBER - SAN JOSE CLINIC- ROSENBERG

Laboratory Demographics

  • CLIA Code: 45D2171406
  • Facility Name: SAN JOSE CLINIC- ROSENBERG
  • Facility Address: 1615 AVENUE E
    ROSENBERG, TX
    ZIP 77471
  • Facility Phone: 713 490-2617
  • Facility Type: Other - NON-PROFIT
  • Facility Type: Waiver
  • Lab Director: MICHAEL RYTTING
  • NPI Number: 1043099328
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2171406
LAB Type Other - NON-PROFIT
Facility Name SAN JOSE CLINIC- ROSENBERG
Street 1615 AVENUE E
City ROSENBERG
State TX
ZIP 77471
Phone 713 490-2617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Other - NON-PROFIT
Lab Director MICHAEL RYTTING

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