45D2209572 CLIA NUMBER - VILLAGEMD OF SOUTHEAST TEXAS, PA

Laboratory Demographics

  • CLIA Code: 45D2209572
  • Facility Name: VILLAGEMD OF SOUTHEAST TEXAS, PA
  • Facility Address: 6467 WOODLANDS PKWY, SUITE A
    THE WOODLANDS, TX
    ZIP 77381
  • Facility Phone: 346 980-2236
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANU KELUR MARIYAPPA
  • NPI Number: 1972880797
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2209572
LAB Type Physician Office
Facility Name VILLAGEMD OF SOUTHEAST TEXAS, PA
Street 6467 WOODLANDS PKWY, SUITE A
City THE WOODLANDS
State TX
ZIP 77381
Phone 346 980-2236
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director ANU KELUR MARIYAPPA

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