45D2159137 CLIA NUMBER - PREMISE HEALTH OF TEXAS MEDICAL, PA

Laboratory Demographics

  • CLIA Code: 45D2159137
  • Facility Name: PREMISE HEALTH OF TEXAS MEDICAL, PA
  • Facility Address: 1700 NORTH HIGHWAY 360
    GRAND PRAIRIE, TX
    ZIP 75050
  • Facility Phone: 817 280-5237
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAREMY JAMES
  • NPI Number: 1396226700
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2159137
LAB Type Physician Office
Facility Name PREMISE HEALTH OF TEXAS MEDICAL, PA
Street 1700 NORTH HIGHWAY 360
City GRAND PRAIRIE
State TX
ZIP 75050
Phone 817 280-5237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Physician Office
Lab Director JAREMY JAMES

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