45D2228408 CLIA NUMBER - VILLAGEMD OF SOUTHEAST TEXAS, PA

Laboratory Demographics

CLIA Number: 45D2228408

Facility Name: VILLAGEMD OF SOUTHEAST TEXAS, PA

Facility Address:
7929 KIRBY DRIVE SUITE A
HOUSTON, TX
ZIP 77054
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Facility Phone Number: 346 980-2236

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790146942

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	45D2228408
LAB Type	Physician Office
Facility Name	VILLAGEMD OF SOUTHEAST TEXAS, PA
Street	7929 KIRBY DRIVE SUITE A
City	HOUSTON
State	TX
ZIP	77054
Phone	346 980-2236
CertificateType	4
CertificateEffectiveDate	6/25/2023
CertificateExpirationDate	6/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024