45D1036207 CLIA NUMBER - DENTON OB/GYN, PA

Laboratory Demographics

CLIA Number: 45D1036207

Facility Name: DENTON OB/GYN, PA

Facility Address:
3337 COLORADO BLVD SUITE 100
DENTON, TX
ZIP 76210
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Facility Phone Number: 940 320-2745

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235309964

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	45D1036207
LAB Type	Physician Office
Facility Name	DENTON OB/GYN, PA
Street	3337 COLORADO BLVD SUITE 100
City	DENTON
State	TX
ZIP	76210
Phone	940 320-2745
CertificateType	4
CertificateEffectiveDate	1/24/2023
CertificateExpirationDate	1/23/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024