45D2114310 CLIA NUMBER - MATTISON PATHOLOGY LLP

Laboratory Demographics

  • CLIA Code: 45D2114310
  • Facility Name: MATTISON PATHOLOGY LLP
  • Facility Address: 4245 NORTH CENTRAL EXPRESSWAY SUITE 420
    DALLAS, TX
    ZIP 75205
  • Facility Phone: 360 527-4580
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. RYAN R. FORTNA
  • NPI Number: 1922551399
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2114310
LAB Type Independent
Facility Name MATTISON PATHOLOGY LLP
Street 4245 NORTH CENTRAL EXPRESSWAY SUITE 420
City DALLAS
State TX
ZIP 75205
Phone 360 527-4580
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Independent
Lab Director DR. RYAN R. FORTNA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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