45D2166986 CLIA NUMBER - LABORATORY CORPORATION OF AMERICA

Laboratory Demographics

  • CLIA Code: 45D2166986
  • Facility Name: LABORATORY CORPORATION OF AMERICA
  • Facility Address: 3141 E BROAD ST SUITE 321
    MANSFIELD, TX
    ZIP 76063
  • Facility Phone: 817 473-1886
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: JENELLE LEE
  • NPI Number: 1114085867
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 45D2166986
LAB Type Independent
Facility Name LABORATORY CORPORATION OF AMERICA
Street 3141 E BROAD ST SUITE 321
City MANSFIELD
State TX
ZIP 76063
Phone 817 473-1886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Independent
Lab Director JENELLE LEE

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