45D0480865 CLIA NUMBER - JACK D SEIDEL MD

Laboratory Demographics

  • CLIA Code: 45D0480865
  • Facility Name: JACK D SEIDEL MD
  • Facility Address: 4100 ALPHA RD SUITE 650
    FARMERS BRANCH, TX
    ZIP 75244
  • Facility Phone: 214 243-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACK D. SEIDEL
  • NPI Number: 1962613026
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D0480865
LAB Type Physician Office
Facility Name JACK D SEIDEL MD
Street 4100 ALPHA RD SUITE 650
City FARMERS BRANCH
State TX
ZIP 75244
Phone 214 243-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Physician Office
Lab Director JACK D. SEIDEL

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