45D2020007 CLIA NUMBER - MARATHON - DPSG IRVING

Laboratory Demographics

  • CLIA Code: 45D2020007
  • Facility Name: MARATHON - DPSG IRVING
  • Facility Address: 2304 CENTURY CENTER BLVD
    IRVING, TX
    ZIP 75062
  • Facility Phone: 866 434-3255
  • Facility Type: Other - EMPLOYER HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: NAZIA AJANI
  • NPI Number: 1174248413
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2020007
LAB Type Other - EMPLOYER HEALTH CLINIC
Facility Name MARATHON - DPSG IRVING
Street 2304 CENTURY CENTER BLVD
City IRVING
State TX
ZIP 75062
Phone 866 434-3255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Other - EMPLOYER HEALTH CLINIC
Lab Director NAZIA AJANI

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