45D1008858 CLIA NUMBER - LONE STAR GASTROENTEROLOGY PA

Laboratory Demographics

  • CLIA Code: 45D1008858
  • Facility Name: LONE STAR GASTROENTEROLOGY PA
  • Facility Address: 4101 W SPRING CREEK PKWY, SUITE 400
    PLANO, TX
    ZIP 75024
  • Facility Phone: 972 599-7879
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GOWRI BALACHANDAR
  • NPI Number: 1821553454
  • Taxonomy: 207QB0002X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1008858
LAB Type Physician Office
Facility Name LONE STAR GASTROENTEROLOGY PA
Street 4101 W SPRING CREEK PKWY, SUITE 400
City PLANO
State TX
ZIP 75024
Phone 972 599-7879
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director GOWRI BALACHANDAR

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