45D2260779 CLIA NUMBER - UPPER VALLEY DIALYSIS ACCESS CENTER LLC

Laboratory Demographics

  • CLIA Code: 45D2260779
  • Facility Name: UPPER VALLEY DIALYSIS ACCESS CENTER LLC
  • Facility Address: 1203 ST CLAIRE BUILDING UNIT 13 & 14
    MISSION, TX
    ZIP 78572
  • Facility Phone: 956 600-8899
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CHIJIOKE E. OGBU
  • NPI Number: 1184382848
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2260779
LAB Type Ambulatory Surgery Center
Facility Name UPPER VALLEY DIALYSIS ACCESS CENTER LLC
Street 1203 ST CLAIRE BUILDING UNIT 13 & 14
City MISSION
State TX
ZIP 78572
Phone 956 600-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Ambulatory Surgery Center
Lab Director CHIJIOKE E. OGBU

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