45D2171050 CLIA NUMBER - PEDIATRIC KARE KLINIC, PLLC

Laboratory Demographics

  • CLIA Code: 45D2171050
  • Facility Name: PEDIATRIC KARE KLINIC, PLLC
  • Facility Address: 104 EAST US HWY 80, SUITE 190
    FORNEY, TX
    ZIP 75126
  • Facility Phone: 469 602-5277
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DELORIS R. HARWELL
  • NPI Number: 1609348580
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2171050
LAB Type Practitioner Other
Facility Name PEDIATRIC KARE KLINIC, PLLC
Street 104 EAST US HWY 80, SUITE 190
City FORNEY
State TX
ZIP 75126
Phone 469 602-5277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Practitioner Other
Lab Director DELORIS R. HARWELL

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