45D2062701 CLIA NUMBER - LEGENT INTERVENTIONAL PAIN CENTER

Laboratory Demographics

  • CLIA Code: 45D2062701
  • Facility Name: LEGENT INTERVENTIONAL PAIN CENTER
  • Facility Address: 461 WESTPARK WAY
    EULESS, TX
    ZIP 76040
  • Facility Phone: 817 553-3627
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KAMLESH J. SISODIYA
  • NPI Number: 1972941714
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2062701
LAB Type Ambulatory Surgery Center
Facility Name LEGENT INTERVENTIONAL PAIN CENTER
Street 461 WESTPARK WAY
City EULESS
State TX
ZIP 76040
Phone 817 553-3627
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Ambulatory Surgery Center
Lab Director KAMLESH J. SISODIYA

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