45D2191903 CLIA NUMBER - MID CITIES DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 45D2191903
  • Facility Name: MID CITIES DIRECT PRIMARY CARE
  • Facility Address: 1501 HUGHES RD SUITE 103
    GRAPEVINE, TX
    ZIP 76051
  • Facility Phone: 817 284-9875
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KARA C. FARLEY
  • NPI Number: 1679967145
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2191903
LAB Type Physician Office
Facility Name MID CITIES DIRECT PRIMARY CARE
Street 1501 HUGHES RD SUITE 103
City GRAPEVINE
State TX
ZIP 76051
Phone 817 284-9875
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director KARA C. FARLEY

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