45D2209491 CLIA NUMBER - BROADWAY FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 45D2209491
  • Facility Name: BROADWAY FAMILY CLINIC
  • Facility Address: 3129 KINGSLEY DRIVE SUITE 340
    PEARLAND, TX
    ZIP 77584
  • Facility Phone: 832 462-9574
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KASHIF A. SIDDIQUI
  • NPI Number: 1366917528
  • Taxonomy: 261QE0002X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2209491
LAB Type Physician Office
Facility Name BROADWAY FAMILY CLINIC
Street 3129 KINGSLEY DRIVE SUITE 340
City PEARLAND
State TX
ZIP 77584
Phone 832 462-9574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2025
Certificate Expiration Date 1/12/2027
Facility Type Physician Office
Lab Director KASHIF A. SIDDIQUI

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