45D1060759 CLIA NUMBER - VIJAYA NAMA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D1060759
  • Facility Name: VIJAYA NAMA FAMILY PRACTICE
  • Facility Address: 4800 N GALLOWAY AVE SUITE 300
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: (972) 303-3000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAYA NAMA
  • NPI Number: 1073520177
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1060759
LAB Type Physician Office
Facility Name VIJAYA NAMA FAMILY PRACTICE
Street 4800 N GALLOWAY AVE SUITE 300
City MESQUITE
State TX
ZIP 75150
Phone 9723033000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Physician Office
Lab Director VIJAYA NAMA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/29/2026