45D2174510 CLIA NUMBER - MACARTHUR MEDICAL CENTER, PLLC

Laboratory Demographics

  • CLIA Code: 45D2174510
  • Facility Name: MACARTHUR MEDICAL CENTER, PLLC
  • Facility Address: 3095 KINGSWOOD BLVD SUITE 250
    GRAND PRAIRIE, TX
    ZIP 75052
  • Facility Phone: 972 256-3700
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD DOWNS WAGNER
  • NPI Number: 1326320367
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D2174510
LAB Type Physician Office
Facility Name MACARTHUR MEDICAL CENTER, PLLC
Street 3095 KINGSWOOD BLVD SUITE 250
City GRAND PRAIRIE
State TX
ZIP 75052
Phone 972 256-3700
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Physician Office
Lab Director RICHARD DOWNS WAGNER

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