45D2125162 CLIA NUMBER - PRIMARY VISITING CLINICIANS, PLLC DBA PCV FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D2125162
  • Facility Name: PRIMARY VISITING CLINICIANS, PLLC DBA PCV FAMILY PRACTICE
  • Facility Address: 3334 BROADWAY BLVD SUITE 422
    GARLAND, TX
    ZIP 75043
  • Facility Phone: 972 979-7408
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZAINABU KOROMA
  • NPI Number: 1720468390
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2125162
LAB Type Physician Office
Facility Name PRIMARY VISITING CLINICIANS, PLLC DBA PCV FAMILY PRACTICE
Street 3334 BROADWAY BLVD SUITE 422
City GARLAND
State TX
ZIP 75043
Phone 972 979-7408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Physician Office
Lab Director ZAINABU KOROMA

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