45D1090274 CLIA NUMBER - KUSI FORDJOUR,MD, PA

Laboratory Demographics

  • CLIA Code: 45D1090274
  • Facility Name: KUSI FORDJOUR,MD, PA
  • Facility Address: 2505 BOLTON BOONE DR SUITE 101
    DESOTO, TX
    ZIP 75115
  • Facility Phone: 214 673-3934
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KUSI FORDJOUR,MD
  • NPI Number: 1780623074
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1090274
LAB Type Physician Office
Facility Name KUSI FORDJOUR,MD, PA
Street 2505 BOLTON BOONE DR SUITE 101
City DESOTO
State TX
ZIP 75115
Phone 214 673-3934
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director KUSI FORDJOUR,MD

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