45D2177699 CLIA NUMBER - SANDSTONE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 45D2177699

Facility Name: SANDSTONE FAMILY MEDICINE

Facility Address:
795 FISH CREEK THOROUGHFARE STE 270
MONTGOMERY, TX
ZIP 77316
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Facility Phone Number: 936 436-8121

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134772270

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2177699
LAB Type	Physician Office
Facility Name	SANDSTONE FAMILY MEDICINE
Street	795 FISH CREEK THOROUGHFARE STE 270
City	MONTGOMERY
State	TX
ZIP	77316
Phone	936 436-8121
CertificateType	4
CertificateEffectiveDate	1/16/2024
CertificateExpirationDate	1/15/2026
FacilityType	Waiver

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