45D2032200 CLIA NUMBER - DFW VASCULAR GROUP

Laboratory Demographics

  • CLIA Code: 45D2032200
  • Facility Name: DFW VASCULAR GROUP
  • Facility Address: 2801 BOLTON BOONE, SUITE 105
    DESOTO, TX
    ZIP 75115
  • Facility Phone: 214 946-5165
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAM S. AHN
  • NPI Number: 1467585786
  • Taxonomy: 2086S0129X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 45D2032200
LAB Type Physician Office
Facility Name DFW VASCULAR GROUP
Street 2801 BOLTON BOONE, SUITE 105
City DESOTO
State TX
ZIP 75115
Phone 214 946-5165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Physician Office
Lab Director SAM S. AHN

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