45D1068691 CLIA NUMBER - KHUONG PHAN, DO, PA

Laboratory Demographics

  • CLIA Code: 45D1068691
  • Facility Name: KHUONG PHAN, DO, PA
  • Facility Address: 8200 MATLOCK ROAD, SUITE 100
    ARLINGTON, TX
    ZIP 76002
  • Facility Phone: 817 473-7197
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHUONG O. PHAN DO
  • NPI Number: 1033119540
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1068691
LAB Type Physician Office
Facility Name KHUONG PHAN, DO, PA
Street 8200 MATLOCK ROAD, SUITE 100
City ARLINGTON
State TX
ZIP 76002
Phone 817 473-7197
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director KHUONG O. PHAN DO

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