45D0718382 CLIA NUMBER - STELLA MATTINA HEALTH INC

Laboratory Demographics

  • CLIA Code: 45D0718382
  • Facility Name: STELLA MATTINA HEALTH INC
  • Facility Address: 901 N GALLOWAY AVE SUITE 107
    MESQUITE, TX
    ZIP 75149
  • Facility Phone: 972 288-1084
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THEODORE J. KRUM
  • NPI Number: 1811004112
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D0718382
LAB Type Physician Office
Facility Name STELLA MATTINA HEALTH INC
Street 901 N GALLOWAY AVE SUITE 107
City MESQUITE
State TX
ZIP 75149
Phone 972 288-1084
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 THEODORE J. KRUM

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