45D2056180 CLIA NUMBER - KINGSBROOK HEALTHCARE SERVICES, PLLC

Home > CLIA Lookup > 45D2056180

Laboratory Demographics

CLIA Number: 45D2056180

Facility Name: KINGSBROOK HEALTHCARE SERVICES, PLLC

Facility Address:
1230 RIVER BEND SUITE 107
DALLAS, TX
ZIP 75247
Get Directions

Facility Phone Number: 214 272-9008

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1023249505

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2056180
LAB Type	Practitioner Other
Facility Name	KINGSBROOK HEALTHCARE SERVICES, PLLC
Street	1230 RIVER BEND SUITE 107
City	DALLAS
State	TX
ZIP	75247
Phone	214 272-9008
CertificateType	4
CertificateEffectiveDate	3/16/2024
CertificateExpirationDate	3/15/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024