45D1022210 CLIA NUMBER - MIDLOTHIAN FAMILY MEDICINE CLINIC PA

Laboratory Demographics

  • CLIA Code: 45D1022210
  • Facility Name: MIDLOTHIAN FAMILY MEDICINE CLINIC PA
  • Facility Address: 200 SILKEN CROSSING #201
    MIDLOTHIAN, TX
    ZIP 76065
  • Facility Phone: 214 733-8001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BOB K. FELTY
  • NPI Number: 1083098214
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1022210
LAB Type Physician Office
Facility Name MIDLOTHIAN FAMILY MEDICINE CLINIC PA
Street 200 SILKEN CROSSING #201
City MIDLOTHIAN
State TX
ZIP 76065
Phone 214 733-8001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Physician Office
Lab Director BOB K. FELTY

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