45D2199709 CLIA NUMBER - MEDICAL CLINIC SU SALUD

Laboratory Demographics

  • CLIA Code: 45D2199709
  • Facility Name: MEDICAL CLINIC SU SALUD
  • Facility Address: 12454 BEECHNUT ST SUITE #12
    HOUSTON, TX
    ZIP 77072
  • Facility Phone: 281 971-4099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANIBAL F. ROSSEL
  • NPI Number: 1235594532
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 45D2199709
LAB Type Physician Office
Facility Name MEDICAL CLINIC SU SALUD
Street 12454 BEECHNUT ST SUITE #12
City HOUSTON
State TX
ZIP 77072
Phone 281 971-4099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Physician Office
Lab Director ANIBAL F. ROSSEL

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