45D2177906 CLIA NUMBER - VISION PLAZA, PA DBA VISION PLAZA

Laboratory Demographics

  • CLIA Code: 45D2177906
  • Facility Name: VISION PLAZA, PA DBA VISION PLAZA
  • Facility Address: 312 E RENFRO ST SUITE 107
    BURLESON, TX
    ZIP 76028
  • Facility Phone: 817 295-9696
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDRE T. LE
  • NPI Number: 1912019076
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 45D2177906
LAB Type Physician Office
Facility Name VISION PLAZA, PA DBA VISION PLAZA
Street 312 E RENFRO ST SUITE 107
City BURLESON
State TX
ZIP 76028
Phone 817 295-9696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Physician Office
Lab Director ANDRE T. LE

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