45D0995230 CLIA NUMBER - KELSOM CLINIC INC

Laboratory Demographics

  • CLIA Code: 45D0995230
  • Facility Name: KELSOM CLINIC INC
  • Facility Address: 1202 W PIONEER DRIVE, # 100
    IRVING, TX
    ZIP 75061
  • Facility Phone: 972 254-7272
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CATHERINE N. OKORONKWO MD
  • NPI Number: 1104840594
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0995230
LAB Type Physician Office
Facility Name KELSOM CLINIC INC
Street 1202 W PIONEER DRIVE, # 100
City IRVING
State TX
ZIP 75061
Phone 972 254-7272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Physician Office
Lab Director CATHERINE N. OKORONKWO MD

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