45D2223196 CLIA NUMBER - LEGACY COMMUNITY HEALTH - STAFFORD FOUNTAINS

Laboratory Demographics

  • CLIA Code: 45D2223196
  • Facility Name: LEGACY COMMUNITY HEALTH - STAFFORD FOUNTAINS
  • Facility Address: 12540 SUGARDALE DRIVE
    STAFFORD, TX
    ZIP 77477
  • Facility Phone: 713 814-3525
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: RACHANA SUTARIA
  • NPI Number: 1407516677
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2223196
LAB Type Federally Qualified Health Center
Facility Name LEGACY COMMUNITY HEALTH - STAFFORD FOUNTAINS
Street 12540 SUGARDALE DRIVE
City STAFFORD
State TX
ZIP 77477
Phone 713 814-3525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Federally Qualified Health Center
Lab Director RACHANA SUTARIA

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This page was last updated on: 6/4/2025