45D0991686 CLIA NUMBER - TLC PEDIATRICS DR DANIEL MOULTON MD FAAP

Laboratory Demographics

  • CLIA Code: 45D0991686
  • Facility Name: TLC PEDIATRICS DR DANIEL MOULTON MD FAAP
  • Facility Address: 1105 N CENTRAL EXPRESSWAY #250
    ALLEN, TX
    ZIP 75013
  • Facility Phone: 972 747-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL J. MOULTON
  • NPI Number: 1124078258
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D0991686
LAB Type Physician Office
Facility Name TLC PEDIATRICS DR DANIEL MOULTON MD FAAP
Street 1105 N CENTRAL EXPRESSWAY #250
City ALLEN
State TX
ZIP 75013
Phone 972 747-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Physician Office
Lab Director DANIEL J. MOULTON

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