45D0712302 CLIA NUMBER - PEDIATRIC PHYSICIANS PA

Laboratory Demographics

  • CLIA Code: 45D0712302
  • Facility Name: PEDIATRIC PHYSICIANS PA
  • Facility Address: 3101 CHURCHILL DR STE 200
    FLOWER MOUND, TX
    ZIP 75022
  • Facility Phone: 972 691-2100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIRAN HARPAVAT
  • NPI Number: 1356486484
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D0712302
LAB Type Physician Office
Facility Name PEDIATRIC PHYSICIANS PA
Street 3101 CHURCHILL DR STE 200
City FLOWER MOUND
State TX
ZIP 75022
Phone 972 691-2100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director KIRAN HARPAVAT

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