45D2168011 CLIA NUMBER - CARE ATC - JOSEY RANCH

Laboratory Demographics

CLIA Number: 45D2168011

Facility Name: CARE ATC - JOSEY RANCH

Facility Address:
1735 KELLER SPRINGS SUITE 100
CARROLLTON, TX
ZIP 75006
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Facility Phone Number: 918 779-7451

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1598316275

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2168011
LAB Type	Physician Office
Facility Name	CARE ATC - JOSEY RANCH
Street	1735 KELLER SPRINGS SUITE 100
City	CARROLLTON
State	TX
ZIP	75006
Phone	918 779-7451
CertificateType	4
CertificateEffectiveDate	6/19/2023
CertificateExpirationDate	6/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024