45D2105175 CLIA NUMBER - MEDHEALTH-METHODIST TRANSPLANT SPECIALISTS

Laboratory Demographics

  • CLIA Code: 45D2105175
  • Facility Name: MEDHEALTH-METHODIST TRANSPLANT SPECIALISTS
  • Facility Address: 1411 N BECKLEY AVE, PAV III SUITE 268
    DALLAS, TX
    ZIP 75203
  • Facility Phone: 214 884-4700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PEREZ MANTRY
  • NPI Number: 1306339387
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 45D2105175
LAB Type Physician Office
Facility Name MEDHEALTH-METHODIST TRANSPLANT SPECIALISTS
Street 1411 N BECKLEY AVE, PAV III SUITE 268
City DALLAS
State TX
ZIP 75203
Phone 214 884-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director PEREZ MANTRY

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