45D0879428 CLIA NUMBER - KELLY WIMBERLY MD PA

Laboratory Demographics

CLIA Number: 45D0879428

Facility Name: KELLY WIMBERLY MD PA

Facility Address:
17101 PRESTON RD SUITE 200
DALLAS, TX
ZIP 75248
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Facility Phone Number: 972 239-4441

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1578589842

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D0879428
LAB Type	Physician Office
Facility Name	KELLY WIMBERLY MD PA
Street	17101 PRESTON RD SUITE 200
City	DALLAS
State	TX
ZIP	75248
Phone	972 239-4441
CertificateType	1
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024