45D2188373 CLIA NUMBER - LEGACY COMMUNITY HEALTH-BEAUMONT NORTH ST

Laboratory Demographics

  • CLIA Code: 45D2188373
  • Facility Name: LEGACY COMMUNITY HEALTH-BEAUMONT NORTH ST
  • Facility Address: 3030 NORTH ST STE 500
    BEAUMONT, TX
    ZIP 77702
  • Facility Phone: 409 333-1377
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LUIS G. TAYLOR
  • NPI Number: 1538149869
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2188373
LAB Type Physician Office
Facility Name LEGACY COMMUNITY HEALTH-BEAUMONT NORTH ST
Street 3030 NORTH ST STE 500
City BEAUMONT
State TX
ZIP 77702
Phone 409 333-1377
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Physician Office
Lab Director LUIS G. TAYLOR

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