45D1088483 CLIA NUMBER - MEDHEALTH RICHARDSON MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 45D1088483
  • Facility Name: MEDHEALTH RICHARDSON MEDICAL GROUP
  • Facility Address: 2821 E PRESIDENT GEORGE BUSH HWY SUITE 103
    RICHARDSON, TX
    ZIP 75082
  • Facility Phone: 469 204-6980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICK BOOTHE
  • NPI Number: 1558854547
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 45D1088483
LAB Type Physician Office
Facility Name MEDHEALTH RICHARDSON MEDICAL GROUP
Street 2821 E PRESIDENT GEORGE BUSH HWY SUITE 103
City RICHARDSON
State TX
ZIP 75082
Phone 469 204-6980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Physician Office
Lab Director PATRICK BOOTHE

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