45D2188117 CLIA NUMBER - SOUTHFORK SENIOR CARE, LLC DBA ORCHARD PARK OF SOUTHFORK

Laboratory Demographics

  • CLIA Code: 45D2188117
  • Facility Name: SOUTHFORK SENIOR CARE, LLC DBA ORCHARD PARK OF SOUTHFORK
  • Facility Address: 3151 SOUTHFORK PARKWAY
    MANVEL, TX
    ZIP 77578
  • Facility Phone: 713 960-4727
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JUDITH GOODSON
  • NPI Number: 1871275305
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2188117
LAB Type Assisted Living Facility
Facility Name SOUTHFORK SENIOR CARE, LLC DBA ORCHARD PARK OF SOUTHFORK
Street 3151 SOUTHFORK PARKWAY
City MANVEL
State TX
ZIP 77578
Phone 713 960-4727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Assisted Living Facility
Lab Director JUDITH GOODSON

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