45D1052228 CLIA NUMBER - LIDA AGHDAM, MD

Laboratory Demographics

  • CLIA Code: 45D1052228
  • Facility Name: LIDA AGHDAM, MD
  • Facility Address: 4819 STATE HWY 121 #14
    THE COLONY, TX
    ZIP 75056
  • Facility Phone: 817 488-7878
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LIDA AGHDAM
  • NPI Number: 1376572115
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1052228
LAB Type Physician Office
Facility Name LIDA AGHDAM, MD
Street 4819 STATE HWY 121 #14
City THE COLONY
State TX
ZIP 75056
Phone 817 488-7878
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 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director LIDA AGHDAM

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