45D2211573 CLIA NUMBER - MODERA CLINIC

Laboratory Demographics

  • CLIA Code: 45D2211573
  • Facility Name: MODERA CLINIC
  • Facility Address: 2381 E UNIVERSITY DR SUITE 50
    PROSPER, TX
    ZIP 75078
  • Facility Phone: 972 987-0458
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEFANIE HUBER
  • NPI Number: 1962957639
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2211573
LAB Type Physician Office
Facility Name MODERA CLINIC
Street 2381 E UNIVERSITY DR SUITE 50
City PROSPER
State TX
ZIP 75078
Phone 972 987-0458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Physician Office
Lab Director STEFANIE HUBER

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