45D2178665 CLIA NUMBER - PRIME CARE HEALTH SOLUTIONS, LLC

Laboratory Demographics

  • CLIA Code: 45D2178665
  • Facility Name: PRIME CARE HEALTH SOLUTIONS, LLC
  • Facility Address: 2100 N STATE HWY 360 SUITE 1906A
    GRAND PRAIRIE, TX
    ZIP 75050
  • Facility Phone: 214 613-2019
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOY E. AGUWA
  • NPI Number: 1083173652
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2178665
LAB Type Practitioner Other
Facility Name PRIME CARE HEALTH SOLUTIONS, LLC
Street 2100 N STATE HWY 360 SUITE 1906A
City GRAND PRAIRIE
State TX
ZIP 75050
Phone 214 613-2019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Practitioner Other
Lab Director JOY E. AGUWA

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