45D2127038 CLIA NUMBER - PROCARE LAKEWOOD ER, LLC

Laboratory Demographics

  • CLIA Code: 45D2127038
  • Facility Name: PROCARE LAKEWOOD ER, LLC
  • Facility Address: 6101 E MOCKINGBIRD LANE
    DALLAS, TX
    ZIP 75214
  • Facility Phone: 469 372-1122
  • Facility Type: Other - FSER
  • Facility Type: Accreditation
  • Lab Director: DR. JACK BUTLER
  • NPI Number: 1316315997
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 45D2127038
LAB Type Other - FSER
Facility Name PROCARE LAKEWOOD ER, LLC
Street 6101 E MOCKINGBIRD LANE
City DALLAS
State TX
ZIP 75214
Phone 469 372-1122
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 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Other - FSER
Lab Director DR. JACK BUTLER

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