45D2003478 CLIA NUMBER - X-TRA HEALTH CARE SERVICES, INC

Laboratory Demographics

  • CLIA Code: 45D2003478
  • Facility Name: X-TRA HEALTH CARE SERVICES, INC
  • Facility Address: 777 S CENTRAL EXPRESSWAY SUITE 7H
    RICHARDSON, TX
    ZIP 75080
  • Facility Phone: 214 388-0200
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: GWENDOLYNE SERIKI
  • NPI Number: 1588800320
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D2003478
LAB Type Home Health Agency
Facility Name X-TRA HEALTH CARE SERVICES, INC
Street 777 S CENTRAL EXPRESSWAY SUITE 7H
City RICHARDSON
State TX
ZIP 75080
Phone 214 388-0200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Home Health Agency
Lab Director GWENDOLYNE SERIKI

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This page was last updated on: 6/4/2025