45D1099710 CLIA NUMBER - SHYLESH GANTA MD PA

Laboratory Demographics

  • CLIA Code: 45D1099710
  • Facility Name: SHYLESH GANTA MD PA
  • Facility Address: 3401 GREENBRIAR DR STE 100
    MIDLAND, TX
    ZIP 79707
  • Facility Phone: 432 686-0000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAPNA CHILKA
  • NPI Number: 1124217310
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1099710
LAB Type Physician Office
Facility Name SHYLESH GANTA MD PA
Street 3401 GREENBRIAR DR STE 100
City MIDLAND
State TX
ZIP 79707
Phone 432 686-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Physician Office
Lab Director SAPNA CHILKA

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