45D2163625 CLIA NUMBER - FOREST LANE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 45D2163625
  • Facility Name: FOREST LANE PEDIATRICS
  • Facility Address: 1600 REPUBLIC PKWY SUITE 120
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 972 284-7770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALD BLAIR
  • NPI Number: 1225173107
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2163625
LAB Type Physician Office
Facility Name FOREST LANE PEDIATRICS
Street 1600 REPUBLIC PKWY SUITE 120
City MESQUITE
State TX
ZIP 75150
Phone 972 284-7770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Physician Office
Lab Director RONALD BLAIR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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