45D2184931 CLIA NUMBER - MPP INFUSION CENTER OF TYLER, LLC

Laboratory Demographics

CLIA Number: 45D2184931

Facility Name: MPP INFUSION CENTER OF TYLER, LLC

Facility Address:
6115 NEW COPELAND ROAD, SUITE 130
TYLER, TX
ZIP 75703
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Facility Phone Number: 720 460-7200

Facility Type: Other - INFUSION CENTER

Certificate Type: Waiver

NPI Number: 1952812109

Taxonomy: 261QI0500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2184931
LAB Type	Other - INFUSION CENTER
Facility Name	MPP INFUSION CENTER OF TYLER, LLC
Street	6115 NEW COPELAND ROAD, SUITE 130
City	TYLER
State	TX
ZIP	75703
Phone	720 460-7200
CertificateType	4
CertificateEffectiveDate	5/27/2022
CertificateExpirationDate	5/26/2024
FacilityType	Waiver

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