45D2317671 CLIA NUMBER - COSTUS MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D2317671
  • Facility Name: COSTUS MEDICAL CLINIC
  • Facility Address: 2710 FM 1092 RD, SUITE E
    MISSOURI CITY, TX
    ZIP 77459
  • Facility Phone: 832 645-4156
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL ZANN MCMAHAN
  • NPI Number: 1336906346
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2317671
LAB Type Physician Office
Facility Name COSTUS MEDICAL CLINIC
Street 2710 FM 1092 RD, SUITE E
City MISSOURI CITY
State TX
ZIP 77459
Phone 832 645-4156
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director MICHAEL ZANN MCMAHAN

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