45D1081705 CLIA NUMBER - VIDYASAGAR CHODMELLA, MD,FACC,PA

Laboratory Demographics

  • CLIA Code: 45D1081705
  • Facility Name: VIDYASAGAR CHODMELLA, MD,FACC,PA
  • Facility Address: 4325 N JOSEY LANE, SUITE 204
    CARROLLTON, TX
    ZIP 75010
  • Facility Phone: 972 395-7400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIDYASAGAR CHODIMELLA
  • NPI Number: 1215972419
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1081705
LAB Type Physician Office
Facility Name VIDYASAGAR CHODMELLA, MD,FACC,PA
Street 4325 N JOSEY LANE, SUITE 204
City CARROLLTON
State TX
ZIP 75010
Phone 972 395-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2024
Certificate Expiration Date 3/23/2026
Facility Type Physician Office
Lab Director VIDYASAGAR CHODIMELLA

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