45D2229700 CLIA NUMBER - LEGACY COMMUNITY HEALTH - GALENA PARK ISD - GALENA PARK MIDDLE

Laboratory Demographics

CLIA Number: 45D2229700

Facility Name: LEGACY COMMUNITY HEALTH - GALENA PARK ISD - GALENA PARK MIDDLE

Facility Address:
400 KEENE ST
GALENA PARK, TX
ZIP 77547
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Facility Phone Number: 713 814-3293

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1659943884

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2229700
LAB Type	Federally Qualified Health Center
Facility Name	LEGACY COMMUNITY HEALTH - GALENA PARK ISD - GALENA PARK MIDDLE
Street	400 KEENE ST
City	GALENA PARK
State	TX
ZIP	77547
Phone	713 814-3293
CertificateType	4
CertificateEffectiveDate	7/15/2023
CertificateExpirationDate	7/14/2025
FacilityType	Waiver

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