45D2016159 CLIA NUMBER - STARSIDE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 45D2016159
  • Facility Name: STARSIDE PEDIATRICS
  • Facility Address: 1518 LEGACY DR SUITE 110
    FRISCO, TX
    ZIP 75034
  • Facility Phone: 214 494-4212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SARA L. GONDOL
  • NPI Number: 1124335765
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2016159
LAB Type Physician Office
Facility Name STARSIDE PEDIATRICS
Street 1518 LEGACY DR SUITE 110
City FRISCO
State TX
ZIP 75034
Phone 214 494-4212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director SARA L. GONDOL

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