45D2163784 CLIA NUMBER - STAR PEDIATRIC GROUP

Laboratory Demographics

  • CLIA Code: 45D2163784
  • Facility Name: STAR PEDIATRIC GROUP
  • Facility Address: 541 W MAIN ST SUITE 110
    LEWISVILLE, TX
    ZIP 75057
  • Facility Phone: 469 293-8561
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SINDHU E. PHILIP
  • NPI Number: 1174008692
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2163784
LAB Type Physician Office
Facility Name STAR PEDIATRIC GROUP
Street 541 W MAIN ST SUITE 110
City LEWISVILLE
State TX
ZIP 75057
Phone 469 293-8561
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director SINDHU E. PHILIP

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