45D2255276 CLIA NUMBER - MI BIENESTAR CLINICA HISPANA

Laboratory Demographics

CLIA Number: 45D2255276

Facility Name: MI BIENESTAR CLINICA HISPANA

Facility Address:
8511 N HOUSTON ROSSLYN RD SUITE 220
HOUSTON, TX
ZIP 77088
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Facility Phone Number: 281 741-3204

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1265215909

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	45D2255276
LAB Type	Physician Office
Facility Name	MI BIENESTAR CLINICA HISPANA
Street	8511 N HOUSTON ROSSLYN RD SUITE 220
City	HOUSTON
State	TX
ZIP	77088
Phone	281 741-3204
CertificateType	4
CertificateEffectiveDate	3/11/2024
CertificateExpirationDate	3/10/2026
FacilityType	Waiver

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