45D2205329 CLIA NUMBER - PELICAN BAY OF BEAUMONT

Laboratory Demographics

  • CLIA Code: 45D2205329
  • Facility Name: PELICAN BAY OF BEAUMONT
  • Facility Address: 2501 SOUTH MAJOR DRIVE
    BEAUMONT, TX
    ZIP 77707
  • Facility Phone: 409 860-3500
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTINA L. TRENTHAM
  • NPI Number: 1861767832
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2205329
LAB Type Assisted Living Facility
Facility Name PELICAN BAY OF BEAUMONT
Street 2501 SOUTH MAJOR DRIVE
City BEAUMONT
State TX
ZIP 77707
Phone 409 860-3500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Assisted Living Facility
Lab Director CHRISTINA L. TRENTHAM

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