45D0480580 CLIA NUMBER - TED E FOGWELL, MD, PA

Laboratory Demographics

  • CLIA Code: 45D0480580
  • Facility Name: TED E FOGWELL, MD, PA
  • Facility Address: 8160 WALNUT HILL LANE # 220
    DALLAS, TX
    ZIP 75231
  • Facility Phone: (214) 750-0980
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TED E. FOGWELL
  • NPI Number: 1679532840
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D0480580
LAB Type Physician Office
Facility Name TED E FOGWELL, MD, PA
Street 8160 WALNUT HILL LANE # 220
City DALLAS
State TX
ZIP 75231
Phone 2147500980
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Physician Office
Lab Director TED E. FOGWELL

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This page was last updated on: 5/18/2026