45D0920644 CLIA NUMBER - WILLOW BEND FAMILY MEDICINE PA

Laboratory Demographics

  • CLIA Code: 45D0920644
  • Facility Name: WILLOW BEND FAMILY MEDICINE PA
  • Facility Address: 6124 WEST PARKER ROAD STE 138 MEDICAL OFFICE BUILDING 3
    PLANO, TX
    ZIP 75093
  • Facility Phone: 972 981-7000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT A. COOK
  • NPI Number: 1073988135
  • Taxonomy: 246ZC0007X - Specialist/Technologist, Other

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CLIA Record

Field Name Field Value
CLIA Number 45D0920644
LAB Type Physician Office
Facility Name WILLOW BEND FAMILY MEDICINE PA
Street 6124 WEST PARKER ROAD STE 138 MEDICAL OFFICE BUILDING 3
City PLANO
State TX
ZIP 75093
Phone 972 981-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Physician Office
Lab Director ROBERT A. COOK

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