45D0691161 CLIA NUMBER - NORTH TEXAS KIDNEY DISEASE

Laboratory Demographics

  • CLIA Code: 45D0691161
  • Facility Name: NORTH TEXAS KIDNEY DISEASE
  • Facility Address: 1600 WATERS RIDGE DRIVE SUITE A
    LEWISVILLE, TX
    ZIP 75057
  • Facility Phone: 972 219-0558
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE BAKER
  • NPI Number: 1972988699
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D0691161
LAB Type Physician Office
Facility Name NORTH TEXAS KIDNEY DISEASE
Street 1600 WATERS RIDGE DRIVE SUITE A
City LEWISVILLE
State TX
ZIP 75057
Phone 972 219-0558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director BRUCE BAKER

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