45D1097547 CLIA NUMBER - STACY L TERRY, MD, PA

Laboratory Demographics

  • CLIA Code: 45D1097547
  • Facility Name: STACY L TERRY, MD, PA
  • Facility Address: 4040 LEGACY DRIVE, SUITE 201
    FRISCO, TX
    ZIP 75034
  • Facility Phone: 972 668-6705
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACY L. TERRY
  • NPI Number: 1417921008
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D1097547
LAB Type Physician Office
Facility Name STACY L TERRY, MD, PA
Street 4040 LEGACY DRIVE, SUITE 201
City FRISCO
State TX
ZIP 75034
Phone 972 668-6705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Physician Office
Lab Director STACY L. TERRY

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