45D1095290 CLIA NUMBER - WEST PLANO DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D1095290
  • Facility Name: WEST PLANO DIALYSIS
  • Facility Address: 5036 TENNYSON PKWY
    PLANO, TX
    ZIP 75024
  • Facility Phone: 972 608-1089
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JESSIE GEORGE
  • NPI Number: 1417248709
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1095290
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WEST PLANO DIALYSIS
Street 5036 TENNYSON PKWY
City PLANO
State TX
ZIP 75024
Phone 972 608-1089
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JESSIE GEORGE

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