45D1036591 CLIA NUMBER - FATIMA E M ALLAM, MD

Laboratory Demographics

CLIA Number: 45D1036591

Facility Name: FATIMA E M ALLAM, MD

Facility Address:
929 N GALLOWAY, #121
MESQUITE, TX
ZIP 75149
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Facility Phone Number: 972 216-1063

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609440007

Taxonomy: 106S00000X - Behavior Technician
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

CLIA Record

Field Name	Field Value
CLIA Number	45D1036591
LAB Type	Physician Office
Facility Name	FATIMA E M ALLAM, MD
Street	929 N GALLOWAY, #121
City	MESQUITE
State	TX
ZIP	75149
Phone	972 216-1063
CertificateType	4
CertificateEffectiveDate	2/7/2023
CertificateExpirationDate	2/6/2025
FacilityType	Waiver

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