45D0964231 CLIA NUMBER - CORRIDOR PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 45D0964231
  • Facility Name: CORRIDOR PRIMARY CARE
  • Facility Address: 4221 BENNOR RD #205
    KYLE, TX
    ZIP 78640
  • Facility Phone: 512 392-1700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. GRADY
  • NPI Number: 1124050836
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D0964231
LAB Type Physician Office
Facility Name CORRIDOR PRIMARY CARE
Street 4221 BENNOR RD #205
City KYLE
State TX
ZIP 78640
Phone 512 392-1700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director MICHAEL J. GRADY

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