45D2075809 CLIA NUMBER - BOARDWALK OB/GYN ASSOCIATES

Laboratory Demographics

  • CLIA Code: 45D2075809
  • Facility Name: BOARDWALK OB/GYN ASSOCIATES
  • Facility Address: 4085 OHIO DR SUITE 100
    FRISCO, TX
    ZIP 75035
  • Facility Phone: 972 406-9911
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MALATHI V. ELLIS
  • NPI Number: 1427426295
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 45D2075809
LAB Type Physician Office
Facility Name BOARDWALK OB/GYN ASSOCIATES
Street 4085 OHIO DR SUITE 100
City FRISCO
State TX
ZIP 75035
Phone 972 406-9911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director MALATHI V. ELLIS

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