45D2148120 CLIA NUMBER - MAIN MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D2148120
  • Facility Name: MAIN MEDICAL CLINIC
  • Facility Address: 2670 LAKE VISTA DR #101
    LEWISVILLE, TX
    ZIP 75067
  • Facility Phone: 972 245-2876
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SIMON LIM
  • NPI Number: 1144689373
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2148120
LAB Type Physician Office
Facility Name MAIN MEDICAL CLINIC
Street 2670 LAKE VISTA DR #101
City LEWISVILLE
State TX
ZIP 75067
Phone 972 245-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director SIMON LIM

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