45D2179011 CLIA NUMBER - MITCHELL HUEBNER, MD, PLLC

Laboratory Demographics

CLIA Number: 45D2179011

Facility Name: MITCHELL HUEBNER, MD, PLLC

Facility Address:
5477 GLEN LAKES DR SUITE 135
DALLAS, TX
ZIP 75231
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Facility Phone Number: 214 361-2277

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801436753

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2179011
LAB Type	Physician Office
Facility Name	MITCHELL HUEBNER, MD, PLLC
Street	5477 GLEN LAKES DR SUITE 135
City	DALLAS
State	TX
ZIP	75231
Phone	214 361-2277
CertificateType	4
CertificateEffectiveDate	2/13/2024
CertificateExpirationDate	2/12/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024