45D1060381 CLIA NUMBER - PEDIATRIC CLINIC OF MESQUITE

Laboratory Demographics

  • CLIA Code: 45D1060381
  • Facility Name: PEDIATRIC CLINIC OF MESQUITE
  • Facility Address: 3230 IH 30,SUITE 100
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 972 682-1791
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERNESTO NUNEZ
  • NPI Number: 1417177841
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D1060381
LAB Type Physician Office
Facility Name PEDIATRIC CLINIC OF MESQUITE
Street 3230 IH 30,SUITE 100
City MESQUITE
State TX
ZIP 75150
Phone 972 682-1791
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Physician Office
Lab Director ERNESTO NUNEZ

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