45D2284480 CLIA NUMBER - LIFELINE URGENT CARE-BRIDGE CITY

Laboratory Demographics

CLIA Number: 45D2284480

Facility Name: LIFELINE URGENT CARE-BRIDGE CITY

Facility Address:
2219 TEXAS AVE
BRIDGE CITY, TX
ZIP 77611
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Facility Phone Number: 409 779-7740

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508391962

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2284480
LAB Type	Physician Office
Facility Name	LIFELINE URGENT CARE-BRIDGE CITY
Street	2219 TEXAS AVE
City	BRIDGE CITY
State	TX
ZIP	77611
Phone	409 779-7740
CertificateType	4
CertificateEffectiveDate	6/23/2023
CertificateExpirationDate	6/22/2025
FacilityType	Waiver

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