45D2191593 CLIA NUMBER - THE LEGACY MIDTOWN PARK, INC

Laboratory Demographics

  • CLIA Code: 45D2191593
  • Facility Name: THE LEGACY MIDTOWN PARK, INC
  • Facility Address: 8280 MANDERVILLE LN
    DALLAS, TX
    ZIP 75231
  • Facility Phone: (469) 497-3888
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER RANGEL
  • NPI Number: 1013546118
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2191593
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name THE LEGACY MIDTOWN PARK, INC
Street 8280 MANDERVILLE LN
City DALLAS
State TX
ZIP 75231
Phone 4694973888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIFER RANGEL

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This page was last updated on: 5/18/2026