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45D2198458 CLIA NUMBER - BETHESDA FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 45D2198458

Facility Name: BETHESDA FAMILY PRACTICE

Facility Address:
873 S STEMMON FRWY SUITE 100
LEWISVILLE, TX
ZIP 75067
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Facility Phone Number: 214 377-0541

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1003862947

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 45D2198458
LAB Type Physician Office
Facility Name BETHESDA FAMILY PRACTICE
Street 873 S STEMMON FRWY SUITE 100
City LEWISVILLE
State TX
ZIP 75067
Phone 214 377-0541
CertificateType 4
CertificateEffectiveDate 11/2/2022
CertificateExpirationDate 11/1/2024
FacilityType Waiver

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