45D2148469 CLIA NUMBER - CAREATC - CITY OF DALLAS

Laboratory Demographics

CLIA Number: 45D2148469

Facility Name: CAREATC - CITY OF DALLAS

Facility Address:
1500 MARILLA STREET ROOM 1CS
DALLAS, TX
ZIP 75201
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Facility Phone Number: 918 779-7451

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740831098

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2148469
LAB Type	Physician Office
Facility Name	CAREATC - CITY OF DALLAS
Street	1500 MARILLA STREET ROOM 1CS
City	DALLAS
State	TX
ZIP	75201
Phone	918 779-7451
CertificateType	4
CertificateEffectiveDate	5/11/2024
CertificateExpirationDate	5/10/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024