45D2179845 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE-PORT ARTHUR

Laboratory Demographics

  • CLIA Code: 45D2179845
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE-PORT ARTHUR
  • Facility Address: 8555 MEMORIAL BLVD, SUITE 100
    PORT ARTHUR, TX
    ZIP 77640
  • Facility Phone: 409 237-6480
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE A. PEREZ
  • NPI Number: 1568094282
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2179845
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE-PORT ARTHUR
Street 8555 MEMORIAL BLVD, SUITE 100
City PORT ARTHUR
State TX
ZIP 77640
Phone 409 237-6480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Physician Office
Lab Director JOSE A. PEREZ

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