45D2316695 CLIA NUMBER - PRO-ELITE MANAGEMENT SERVICES, CORP

Laboratory Demographics

  • CLIA Code: 45D2316695
  • Facility Name: PRO-ELITE MANAGEMENT SERVICES, CORP
  • Facility Address: 21685 KINGSLAND BLVD
    KATY, TX
    ZIP 77450
  • Facility Phone: 346 594-2104
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EHRENTRAUD JOHANNA EICHELBAUM MD
  • NPI Number: 1922814250
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 45D2316695
LAB Type Physician Office
Facility Name PRO-ELITE MANAGEMENT SERVICES, CORP
Street 21685 KINGSLAND BLVD
City KATY
State TX
ZIP 77450
Phone 346 594-2104
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director EHRENTRAUD JOHANNA EICHELBAUM MD

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