45D1060173 CLIA NUMBER - PROSPER FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 45D1060173
  • Facility Name: PROSPER FAMILY MEDICINE
  • Facility Address: 270 N PRESTON ROAD SUITE 30
    PROSPER, TX
    ZIP 75078
  • Facility Phone: 972 346-2279
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MANJU PANDEY
  • NPI Number: 1821462102
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 45D1060173
LAB Type Physician Office
Facility Name PROSPER FAMILY MEDICINE
Street 270 N PRESTON ROAD SUITE 30
City PROSPER
State TX
ZIP 75078
Phone 972 346-2279
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 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Physician Office
Lab Director MANJU PANDEY

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