45D2100694 CLIA NUMBER - CHMG - CENTENNIAL PEDIATRICS PROSPER

Laboratory Demographics

  • CLIA Code: 45D2100694
  • Facility Name: CHMG - CENTENNIAL PEDIATRICS PROSPER
  • Facility Address: 940 S LEGACY DR STE 20
    PROSPER, TX
    ZIP 75078
  • Facility Phone: 214 389-8801
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER L. NEWTON
  • NPI Number: 1447219308
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2100694
LAB Type Physician Office
Facility Name CHMG - CENTENNIAL PEDIATRICS PROSPER
Street 940 S LEGACY DR STE 20
City PROSPER
State TX
ZIP 75078
Phone 214 389-8801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director CHRISTOPHER L. NEWTON

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