45D2041995 CLIA NUMBER - CENTENNIAL PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2041995
  • Facility Name: CENTENNIAL PRIMARY CARE, PLLC
  • Facility Address: 9925 GILLESPIE DR SUITE 3400
    PLANO, TX
    ZIP 75025
  • Facility Phone: 214 383-0001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NUZHAT F. AHMED
  • NPI Number: 1831458132
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2041995
LAB Type Physician Office
Facility Name CENTENNIAL PRIMARY CARE, PLLC
Street 9925 GILLESPIE DR SUITE 3400
City PLANO
State TX
ZIP 75025
Phone 214 383-0001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Physician Office
Lab Director NUZHAT F. AHMED

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