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45D1088483 CLIA NUMBER - MEDHEALTH RICHARDSON MEDICAL GROUP

Laboratory Demographics

CLIA Number: 45D1088483

Facility Name: MEDHEALTH RICHARDSON MEDICAL GROUP

Facility Address:
2821 E PRESIDENT GEORGE BUSH HWY SUITE 103
RICHARDSON, TX
ZIP 75082
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Facility Phone Number: 469 204-6980

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1558854547

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

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
CertificateType 4
CertificateEffectiveDate 12/28/2023
CertificateExpirationDate 12/27/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024