45D2154047 CLIA NUMBER - COMMUNITYMED FAMILY CARE

Laboratory Demographics

  • CLIA Code: 45D2154047
  • Facility Name: COMMUNITYMED FAMILY CARE
  • Facility Address: 1000 NORTH PRESTON RD SUITE 60B
    PROSPER, TX
    ZIP 75078
  • Facility Phone: 972 521-8172
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY BLOMQUIST
  • NPI Number: 1144467952
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

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CLIA Record

Field Name Field Value
CLIA Number 45D2154047
LAB Type Physician Office
Facility Name COMMUNITYMED FAMILY CARE
Street 1000 NORTH PRESTON RD SUITE 60B
City PROSPER
State TX
ZIP 75078
Phone 972 521-8172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Physician Office
Lab Director GREGORY BLOMQUIST

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