45D2105723 CLIA NUMBER - LORETO HOUSE

Laboratory Demographics

  • CLIA Code: 45D2105723
  • Facility Name: LORETO HOUSE
  • Facility Address: 1100 N BONNIE BRAE STREET
    DENTON, TX
    ZIP 76201
  • Facility Phone: 940 380-8191
  • Facility Type: Other - PREG RESOURCE CTR
  • Facility Type: Waiver
  • Lab Director: RANDY BOLLIG
  • NPI Number: 1891411492
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2105723
LAB Type Other - PREG RESOURCE CTR
Facility Name LORETO HOUSE
Street 1100 N BONNIE BRAE STREET
City DENTON
State TX
ZIP 76201
Phone 940 380-8191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Other - PREG RESOURCE CTR
Lab Director RANDY BOLLIG

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