45D0971981 CLIA NUMBER - JOSE DELEON MD, PA PROFESSIONAL OFFICE BLD 2

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Laboratory Demographics

CLIA Number: 45D0971981

Facility Name: JOSE DELEON MD, PA PROFESSIONAL OFFICE BLD 2

Facility Address:
1330 PRUDENTIAL DR STE 100
DALLAS, TX
ZIP 75235
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Facility Phone Number: 214 879-3505

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1457349524

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	45D0971981
LAB Type	Physician Office
Facility Name	JOSE DELEON MD, PA PROFESSIONAL OFFICE BLD 2
Street	1330 PRUDENTIAL DR STE 100
City	DALLAS
State	TX
ZIP	75235
Phone	214 879-3505
CertificateType	4
CertificateEffectiveDate	12/5/2022
CertificateExpirationDate	12/4/2024
FacilityType	Waiver

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