45D2023060 CLIA NUMBER - LESLIE NELSON MD, PA

Laboratory Demographics

  • CLIA Code: 45D2023060
  • Facility Name: LESLIE NELSON MD, PA
  • Facility Address: 2505 BOLTON BOONE DR, SUITE 107
    DESOTO, TX
    ZIP 75115
  • Facility Phone: 469 759-2323
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LESLIE W. NELSON
  • NPI Number: 1700826088
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2023060
LAB Type Physician Office
Facility Name LESLIE NELSON MD, PA
Street 2505 BOLTON BOONE DR, SUITE 107
City DESOTO
State TX
ZIP 75115
Phone 469 759-2323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Physician Office
Lab Director LESLIE W. NELSON

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