45D2212459 CLIA NUMBER - MOMPREMIER EYE INSTITUTE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2212459
  • Facility Name: MOMPREMIER EYE INSTITUTE, PLLC
  • Facility Address: 1510 N HAMPTON RD SUITE 290
    DESOTO, TX
    ZIP 75115
  • Facility Phone: 469 687-5664
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIKELSON MOMPREMIER
  • NPI Number: 1518415330
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 45D2212459
LAB Type Physician Office
Facility Name MOMPREMIER EYE INSTITUTE, PLLC
Street 1510 N HAMPTON RD SUITE 290
City DESOTO
State TX
ZIP 75115
Phone 469 687-5664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Physician Office
Lab Director MIKELSON MOMPREMIER

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