45D0939420 CLIA NUMBER - BENJAMIN R QUIROZ

Laboratory Demographics

  • CLIA Code: 45D0939420
  • Facility Name: BENJAMIN R QUIROZ
  • Facility Address: 1200 MEDICAL AVENUE #104
    PLANO, TX
    ZIP 75075
  • Facility Phone: (972) 867-5100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN R. QUIROZ
  • NPI Number: 1265466312
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D0939420
LAB Type Physician Office
Facility Name BENJAMIN R QUIROZ
Street 1200 MEDICAL AVENUE #104
City PLANO
State TX
ZIP 75075
Phone 9728675100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director BENJAMIN R. QUIROZ

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This page was last updated on: 5/15/2026