45D2101879 CLIA NUMBER - SAFE HAVEN PSYCHIATRY

Laboratory Demographics

  • CLIA Code: 45D2101879
  • Facility Name: SAFE HAVEN PSYCHIATRY
  • Facility Address: 3447 E RENNER RD STE 120
    PLANO, TX
    ZIP 75074
  • Facility Phone: 469 941-4546
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAVAN K. PAMADURTHI
  • NPI Number: 1841689221
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 45D2101879
LAB Type Physician Office
Facility Name SAFE HAVEN PSYCHIATRY
Street 3447 E RENNER RD STE 120
City PLANO
State TX
ZIP 75074
Phone 469 941-4546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type Physician Office
Lab Director PAVAN K. PAMADURTHI

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