45D2277501 CLIA NUMBER - LIFESTYLE MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 45D2277501
  • Facility Name: LIFESTYLE MEDICINE CLINIC
  • Facility Address: 26077 NELSON WAY, SUITE 1202
    KATY, TX
    ZIP 77494
  • Facility Phone: 713 785-1272
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIRNA PUESAN
  • NPI Number: 1114566023
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2277501
LAB Type Physician Office
Facility Name LIFESTYLE MEDICINE CLINIC
Street 26077 NELSON WAY, SUITE 1202
City KATY
State TX
ZIP 77494
Phone 713 785-1272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Physician Office
Lab Director MIRNA PUESAN

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This page was last updated on: 9/29/2025