45D0712549 CLIA NUMBER - PRACTICAL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 45D0712549
  • Facility Name: PRACTICAL PEDIATRICS
  • Facility Address: 811 IRA E WOODS
    GRAPEVINE, TX
    ZIP 76051
  • Facility Phone: 817 481-3585
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL W. MCCOY
  • NPI Number: 1639351505
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D0712549
LAB Type Physician Office
Facility Name PRACTICAL PEDIATRICS
Street 811 IRA E WOODS
City GRAPEVINE
State TX
ZIP 76051
Phone 817 481-3585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Physician Office
Lab Director MICHAEL W. MCCOY

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