45D2005894 CLIA NUMBER - HARRELL A GRAND, MD, PA

Laboratory Demographics

  • CLIA Code: 45D2005894
  • Facility Name: HARRELL A GRAND, MD, PA
  • Facility Address: 3801 GASTON AVENUE
    DALLAS, TX
    ZIP 75246
  • Facility Phone: 214 824-2121
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTIN L. ASHTON
  • NPI Number: 1982623252
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2005894
LAB Type Physician Office
Facility Name HARRELL A GRAND, MD, PA
Street 3801 GASTON AVENUE
City DALLAS
State TX
ZIP 75246
Phone 214 824-2121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director JUSTIN L. ASHTON

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