45D2191896 CLIA NUMBER - OVER THE MOON PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 45D2191896
  • Facility Name: OVER THE MOON PEDIATRICS, PLLC
  • Facility Address: 17189 I-45 SOUTH SUITE 235
    THE WOODLANDS, TX
    ZIP 77385
  • Facility Phone: 832 539-7532
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHELLE A. SUHENDRA
  • NPI Number: 1104462753
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2191896
LAB Type Physician Office
Facility Name OVER THE MOON PEDIATRICS, PLLC
Street 17189 I-45 SOUTH SUITE 235
City THE WOODLANDS
State TX
ZIP 77385
Phone 832 539-7532
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director MICHELLE A. SUHENDRA

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