45D2175824 CLIA NUMBER - PRIME INTERNAL MEDICINE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 45D2175824
  • Facility Name: PRIME INTERNAL MEDICINE ASSOCIATES
  • Facility Address: 6190 LBJ FRWY SUITE 200
    DALLAS, TX
    ZIP 75240
  • Facility Phone: 972 239-5445
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHALINI KATIKANENI
  • NPI Number: 1538703889
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2175824
LAB Type Physician Office
Facility Name PRIME INTERNAL MEDICINE ASSOCIATES
Street 6190 LBJ FRWY SUITE 200
City DALLAS
State TX
ZIP 75240
Phone 972 239-5445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director SHALINI KATIKANENI

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