45D0479578 CLIA NUMBER - WELLMED AT WHITE ROCK

Laboratory Demographics

  • CLIA Code: 45D0479578
  • Facility Name: WELLMED AT WHITE ROCK
  • Facility Address: 9888 FERGUSON ROAD SUITE 101B
    DALLAS, TX
    ZIP 75228
  • Facility Phone: 214 328-4389
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOSE VALLEJOS
  • NPI Number: 1821340886
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D0479578
LAB Type Physician Office
Facility Name WELLMED AT WHITE ROCK
Street 9888 FERGUSON ROAD SUITE 101B
City DALLAS
State TX
ZIP 75228
Phone 214 328-4389
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Physician Office
Lab Director DR. JOSE VALLEJOS

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