45D1016573 CLIA NUMBER - SONG Y LEE MD FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 45D1016573
  • Facility Name: SONG Y LEE MD FAMILY MEDICINE
  • Facility Address: 6220 COLLEYVILLE BLVD SUITE B
    COLLEYVILLE, TX
    ZIP 76034
  • Facility Phone: 817 849-1368
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: SONG Y. LEE
  • NPI Number: 1194753319
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1016573
LAB Type Community Clinic
Facility Name SONG Y LEE MD FAMILY MEDICINE
Street 6220 COLLEYVILLE BLVD SUITE B
City COLLEYVILLE
State TX
ZIP 76034
Phone 817 849-1368
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Community Clinic
Lab Director SONG Y. LEE

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