45D2215162 CLIA NUMBER - CAGNOLATTI & HENDERSON, INC

Laboratory Demographics

CLIA Number: 45D2215162

Facility Name: CAGNOLATTI & HENDERSON, INC

Facility Address:
1451 EMPIRE CENTRAL DR SUITE 900
DALLAS, TX
ZIP 75247
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Facility Phone Number: 469 372-1277

Facility Type: Other - OUTPATIENT

Certificate Type: Waiver

NPI Number: 1609496488

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	45D2215162
LAB Type	Other - OUTPATIENT
Facility Name	CAGNOLATTI & HENDERSON, INC
Street	1451 EMPIRE CENTRAL DR SUITE 900
City	DALLAS
State	TX
ZIP	75247
Phone	469 372-1277
CertificateType	4
CertificateEffectiveDate	3/1/2023
CertificateExpirationDate	2/28/2025
FacilityType	Waiver

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